diff options
| author | nfenwick <nfenwick@pglaf.org> | 2025-02-05 03:11:31 -0800 |
|---|---|---|
| committer | nfenwick <nfenwick@pglaf.org> | 2025-02-05 03:11:31 -0800 |
| commit | 0ed6d7a5fd06fcfe540421e2c3d051c28eabd400 (patch) | |
| tree | 92413fb14d3b5cc898c0db8937ec17ae54cb06d3 /old/50568-0.txt | |
| parent | 8cb638817661fbf845066472da197e9c25299a4d (diff) | |
Diffstat (limited to 'old/50568-0.txt')
| -rw-r--r-- | old/50568-0.txt | 3997 |
1 files changed, 0 insertions, 3997 deletions
diff --git a/old/50568-0.txt b/old/50568-0.txt deleted file mode 100644 index 01ae977..0000000 --- a/old/50568-0.txt +++ /dev/null @@ -1,3997 +0,0 @@ -Project Gutenberg's The Art of the Bone-Setter, by George Matthews Bennett - -This eBook is for the use of anyone anywhere in the United States and most -other parts of the world at no cost and with almost no restrictions -whatsoever. You may copy it, give it away or re-use it under the terms of -the Project Gutenberg License included with this eBook or online at -www.gutenberg.org. If you are not located in the United States, you'll have -to check the laws of the country where you are located before using this ebook. - -Title: The Art of the Bone-Setter - A Testimony and a Vindication - -Author: George Matthews Bennett - -Release Date: November 28, 2015 [EBook #50568] - -Language: English - -Character set encoding: UTF-8 - -*** START OF THIS PROJECT GUTENBERG EBOOK THE ART OF THE BONE-SETTER *** - - - - -Produced by Turgut Dincer and The Online Distributed -Proofreading Team at http://www.pgdp.net (This file was -produced from images generously made available by The -Internet Archive) - - - - - - - -[Illustration: - - C. W. SMARTT, _Photo._ _Leamington._ - - Faithfully yours - - G.M.B] - - - “_A NEGLECTED CORNER OF THE DOMAIN OF - SURGERY._”—_Lancet._ - - - - - THE - - ART OF THE BONE-SETTER: - - A Testimony and a Vindication. - - WITH NOTES AND ILLUSTRATIONS. - - BY - - GEORGE MATTHEWS BENNETT, - - _Specialist for all kinds of Dislocated Joints, Fractures, - Sprains, etc._ - - WITH PORTRAIT AND NUMEROUS DIAGRAMS. - - London: - - THOMAS MURBY, - 3, LUDGATE CIRCUS BUILDINGS, E.C. - - BIRMINGHAM: CORNISH BROTHERS; WARWICK: COOKE & SON; - COVENTRY: CURTIS; LEAMINGTON: BAILEY; - BANBURY: HARTLEY. - - - LONDON: - PRINTED BY G. J. PARRIS, 57, GREEK STREET, - SOHO, W. - - - TO THE MEMBERS - OF THE - WARWICKSHIRE, NORTH WARWICKSHIRE, - PYTCHLEY, ATHERSTONE, - BICESTER, AND QUORN HUNTS, - AND ALL WHO ARE LIABLE TO INJURIES AND - ACCIDENTS BY “FLOOD AND FIELD,” THIS - VINDICATION AND TESTIMONY - IS INSCRIBED BY - THEIR FAITHFUL SERVANT, - - THE AUTHOR. - - - - -PREFACE. - - -I have been requested, from time to time, by my numerous patients -and friends to publish some record of the Bone-setter’s art, to -which they can refer their relatives and acquaintances, when asked -for some particulars of the cures effected and the pain alleviated -by those who follow the profession of a Bone-setter. I am aware that -in acceding to the request of those who “have the courage of their -convictions,” I am laying myself open to the sneers and innuendos of -the medical profession generally; but as the descendant of a long line -of Bone-setters, who distinguished themselves in the profession they -followed, and whose name was a “household word” in Midland homes -when broken bones, sprains, and dislocations occurred. I feel, as the -inheritor of their practice and in some degree of their reputation, -that I should not be true to myself and to the profession I follow, if -I did not comply with a request so gracefully made by those who have -not only placed their faith in the special practice I pursue, but who -are grateful for the relief from pain they have felt, the ultimate -cures effected, and who wish to make their experiences widely known. - -It was, therefore, with diffidence that I collected from divers sources -the testimony of those who are beyond the reach of suspicion, as to -the cures which those who practise the “Art of the Bone-setter” have -accomplished, even after experienced surgeons have failed; but I was -reassured when I found that these recorded cures, and the repute of -the hundreds of thousands which have not been recorded, but which are -treasured in the memories of a thankful people, had aroused a feeling -of emulation (for I can hardly use any other term) in the surgical -world to adopt some of our methods, which up to a recent period, -they had publicly called the arts of the charlatan and the quack, -and resolved to practise in that “neglected corner of the domain of -surgery” which they had before ridiculed. They did not hesitate to -apply terms of approbrium to us when they were, according to their own -admission, ignorant of our practice, attributing our cures to “luck” -and our popularity to tampering with and trading on the prejudices of -the poor and ignorant, instead of inquiring into their truth. - -Dr. Wharton Hood in his treatise “On Bone-setting (so-called)” has -pointed out that even Sir James Paget (eminent though he is in the -surgical world) spoke in ignorance when, in a clinical lecture -delivered at St. Bartholomew’s in 1867, he detailed the “Cases that -Bone-setters may cure.” His arguments were founded on conjecture, -therefore many of his conclusions were wrong. The great master of the -world of surgery, however, deserves the thanks of the Bone-setters -at large, for he was the first to stand forth in the whole of the -medical profession to announce that the much despised and ridiculed -Bone-setters were in possession of a “knack”—an art—which surgeons -had long overlooked and neglected which tended to alleviate pain and to -restore the use of lost limbs to unfortunate sufferers from accidents -and other external injuries. Dr. Wharton Hood appears to have taken -Sir James Paget’s words to heart, for becoming acquainted with the -late Mr. Richard Hutton, the well-known Bone-setter, whose name so -frequently appears in these pages, he studied his method of procedure -and practice. On the death of that gentleman, Dr. Hood published his -experiences with diagrams, and since that period—now some dozen years -ago a change has taken place in the expression of professional opinion -with respect to the art of the Bone-setter. There is no attempt now -to deny that in practical surgery, that what is called the Empirical -School, can hold its own against mere scientific theory. They have -vindicated our art from the charge of quackery and charlatanism. It -would now appear they now want to secure our practice as well as our -reputation as skillful manipulators. I feel therefore I am more than -justified in thus publishing the testimony of relieved patients, of the -almost recantation of the faculty with respect to our art, to justify -those who have trusted our skill and who have seen no cause to regret -it. - -There may, indeed, be persons who call themselves bone-setters, who are -ignorant, presumptuous, and destitute alike of skill and experience, -whose blunders are charged on the profession generally—there may -be many such whose names are even in the _Medical Registry_—but no -one can read the testimony of men beyond the reach of bribe, and who -have no personal interest to serve, without admitting that there are -Bone-setters who have both skill and experience as well as the ability -to use their acquirements for the benefit of suffering mankind. The -art, it is true, may not be taught in schools, but it is at least as -old as Hippocrates, if not coeval with mankind’s “loss of Eden.” I have -felt it a duty to myself, to my relatives, to my patients and friends, -as well as to my fellow professors of the art to publish this testimony -and vindication. - -I have acknowledged as far as possible the sources from which I -have taken the information in the following pages, if any have been -accidentally omitted, I hope this apology will be sufficient. To those -friends who have helped me with their advice and supervision of these -pages I tender my warmest thanks, as well as to those patients who -have offered their testimony to my own skill and success, and allowed -me to add them to those collected from public sources for this book, -as Turner wrote in his edition to “The Compleat Bone-setter” some -two hundred years ago is not intended for Sutorian or Scissarium -doctors, but I leave them amongst the Caco-Chymists, to boast of their -_arcanas_, but not of their reason, whilst I shall modestly remain - - GEO. MATTHEWS BENNETT, - - Milverton, Leamington, Easter, 1884. - - - - -_ERRATA._ - - Page 16, line 10, for “Captain” _read_ “Copt.” - Page 32, line 14, for “hind” _read_ “him.” - Page 85, line 4, for “former” _read_ “latter.” - Page 123, line 10, for “hreak” _read_ “break.” - Page 132, line 4, _dele_ “which.” - - - PLATE 4, Figure 18, “tibia and fibula” are misprinted for - “ulna and radius.” - - - - -CONTENTS. - - -CHAPTER I.—BONE-SETTERS AND THEIR ART. - -“At present my desire is to have a good Bone-setter.”—Sir J. DENHAM. - - Surgery in the past—_The Compleat Bone-setter_—Old - practitioners—Sneers of the Faculty—Praise by Mr. - Charles Waterton—Mrs. Mapp of Epsom, her success—_Regina - Dal Cin_—German toleration—The late Mr. Richard - Hutton—Testimony of the _Lancet_—Mr. Burbidge of - Frumley—Mr. Joseph Crowther of Wakefield—Egyptian - Bone-setters—Algerian practitioners. 1-18 - - -CHAPTER II.—THE TESTIMONY OF THE PUBLIC. - -“The simple energy of Truth needs no ambiguous -interpreters.”—EURIPIDES. - - Mr. C. Waterton’s case—The testimony of Mr. G. Moore, his - anguish, his hesitation, and his relief. 34 - - -CHAPTER III.—THE TESTIMONY OF THE PUBLIC.—_Continued._ - -“All these are good, and these we must allow, and these are everywhere -in practice now.”—TAYLOR, _the Water Poet_. - - Mr. William Chamber’s testimony—A drummer - practitioner—Various testimonies—An Indian civilian—Mr. - Evan Thomas—A Northant’s Clergyman on the author’s - skill—Cases mentioned by Dr. Wharton Hood—Mr. Hutton’s - skill—The testimony of the Hon. Spencer Ponsonby—The - testimony of Dr. Wharton Hood—A correspondent of _Nature_, on - a scientific Bone-setter. 67 - - - -CHAPTER IV.—THE TESTIMONY OF THE FACULTY. - -“What in the Captain’s but a choleric word is in the soldier rank -blasphemy.” - - Sir James Paget on “Cases that Bone-setters cure”—Change - of opinion—Valuable testimony, and strange doubts—The - opinion of the _British Medical Journal_—The _Lancet_, - on the Bone-setters Art—Doubts of the faculty—Mr. - Archibald Maclaren’s Independent review in _Nature_—His - astonishment—“_Is it quackery?_” 87 - - -CHAPTER V.—THE FACULTY IN DOUBT. - -“Why what you have observed, Sir, seems so impossible.”—BEN JONSON. - - Mr. Howard Marsh’s experience—Mr. Hulke—Dr. Monckton—Dr. - Bruce Clark in doubt—Dr. Keetley—A gleam of truth at the - Clinical Society. 94 - - -CHAPTER VI.—DISPARAGEMENT AND VINDICATION. - -“Who shall decide when doctors disagree.” - - The Jubilee of the Medical Association—Dr. - Howard Marsh on the Bone-setter—False - deductions—Disparagement—Inconsistencies. 102 - - -CHAPTER VII.—VINDICATION. - -“Is this then your wonder? nay, then you shall hear more of my -skill.”—BEN JONSON. - - Mr. R. Dacre Fox relates his experiences—Old Lancashire - Bone-setters—What Bone-setters really do cure—Hints for the - Doubters—A Professional Vindication. 115 - - -CHAPTER VIII.—WHAT BONE-SETTERS CURE. - -“Man’s life, sir, being so short, and then the way that leads unto the -knowledge of ourselves, so long and tedious; each minute should be -precious.”—BEAUMONT & FLETCHER. - - A Bone-setter’s Refutation—The Human Skeleton - and its parts—Liability to Injury—Symptoms—The - _Illustrations_.—Dislocations—Fractures and Ruptures—The - Arteries—Mode of stopping bleeding—Hints for Bystanders. 136 - - -CHAPTER IX.—THE TESTIMONY OF MY PATIENTS. - -“—— If our virtues Did not go forth of us, ’twere all alike as if we -had them not.”—SHAKESPEARE. - - Testimonies from the Lord-Lieutenant of Warwickshire-Lady John - Scott—The Rev. Dr. Dixon, Canon of Worcester—Rev. H. G. de - Bunsen, Rural Dean of Shrifnal—The Rev. R. Skipworth—The - Proprietor of the _Leamington Spa Courier_—Mr. Pluncknett, - etc., etc. 137 - - - - -LIST OF ILLUSTRATIONS. - - - PORTRAIT FRONTISPIECE - - - PLATE I.—The HUMAN SKELETON 1 - - - PLATE II.—DISLOCATIONS:— 19 - - Fig. 1. finger; 2. thumb; 3. hand and radius - forward; 4. radius back; 5. humerus; - 6. shoulder joint; 7. humerus; 8. radius - forward. - - - PLATE III.—DISLOCATIONS:— 35 - - 9. elbow; 10. radius back; 11. jaw; 12. hip - outward; 13. hip inwards. - - - PLATE IV.—DISLOCATIONS:— 68 - - 14. shoulder joint; 15. foot inwards; 16. foot - backwards; 17. knee-joint; 18. elbow. - - - PLATE V.—FRACTURES:— 88 - - 19. un-united fracture; 20. pelvis; 21. humerus; - 22. scapula; 23. jaw; 24. femur. - - - PLATE VI.—FRACTURES:— 95 - - 25. humerus, lower extremity; 26. humerus; - 27. ulna; 28. leg (fibula). - - - PLATE VII.—FRACTURES ETC.:— 103 - - 29. a dislocated spine; 30. Colles’ fracture; - 31. Colles’ fracture; 32. fractured patella; - 33. fractured femur; 34. ruptured - biceps. - - - PLATE VIII.—RUPTURES AND DISLOCATIONS:— 116 - - 36. Pott’s fracture (showing sinews); 37. - Pott’s fracture (badly set); 38. rupture of - the rectus femoris; 39. dislocation of the - metatarsus; 40. dislocation of metatarsal - bones. - - -[Illustration: PLATE I.—THE HUMAN SKELETON.] - - - THE ART - - OF THE - - BONE-SETTER. - - - - -CHAPTER I. - -_BONE-SETTERS AND THEIR ART._ - - - “At present my desire is to have a good Bone-setter.”—_Sir J. - Denham._ - -These words, which Dr. Johnson used to illustrate the word Bone-setter -in his famous dictionary, are better known than any other quotation -bearing on the ancient art of the Bone-setter. There are scattered -through the realms of English literature frequent allusions to those, -who, in times past, practised this special branch of the surgical -art, for the art is as old as the history of civilization itself, and -was probably coeval with the fall of man. The assuaging of pain and -the cure of injuries caused by external violence would naturally -excite the ingenuity of the sufferer and suggest contrivances to those -around them. The Egyptians are credited with a knowledge of surgery, -though they appear to have relied on incantation and astrology for -their medical practice. It is somewhat curious that one of our leading -medical journals should have suggested, within a brief period, that -Bone-setters likewise had recourse to charms and magic—thus credulity, -in those who would ridicule the credulous, repeats itself even in -these enlightened days. The intermediate history of surgery is full of -strange changes and mutations; but, apart from the ordinary practices -of the art, (with its cauterization and its cruel operations,) -the cure of sprains, the reducing of dislocations and fractures, -appears to have been practised by those who were neither leeches -or barber-chirurgeons. In the seventeenth century when Harvey was -studying the circulation of the blood, and Wiseman publishing those -treatises which are the foundation of the modern system of surgery, -one Friar Moulton had published _The Compleat Bone-setter_, and in -the year 1665 an edition of it, “Englished and Enlarged” by Robert -Turner, was printed for Thomas Rooks, of the “Lamb and Ink Bottle” at -the East-end of St. Pauls. I have not been able to trace any separate -publication on this subject during the two centuries which intervened -between it and the work by Dr. Wharton Hood, which was issued in 1871, -in a separate volume, after the greater part of it had appeared in the -_Lancet_. Before the publication of this work, the poor Bone-setter had -to endure contumely and insult at the hands of the faculty. Through -their organs in the press they were denounced either as charlatans -or quacks—as ignorant or presumptuous individuals who traded upon a -“lucky” case to the detriment of the general practitioner. There were -some, indeed, who by intercourse and observation knew that Bone-setters -pursued their calling with success; that the principles which they -followed were sound, gained by experience and improved by constant -practise; that they possessed, in the different parts of the country -where they lived, the confidence of the people, though they were not -educated in the medical or surgical schools. They received their -training at the hands of their predecessors, for the art was a special -one and peculiar to several families whose traditions, observation, -and method of practise were handed down from father to son. Daughters -practised the art with success as well as the sons, and success -crowned their efforts, and amongst them all the family of Matthews were -pre-eminent in the Midlands, and whose representative I have the honour -and privilege to be. - -Mr. Charles Waterton, of Walton Hall, the eminent naturalist, who -bears testimony to the good the Bone-setters have done, tells us, in -the pleasant autobiographical notes to his _Wanderings and Essays -on Natural History_—that every country in Europe, so far as I know -to the contrary, has its Bone-setter independent of the surgeon. In -_Johnson’s Dictionary_, under the article “Bone-setting,” we read that -a Sir John Denham exclaimed “Give me a good Bone-setter!” In Spain -the Bone-setter goes under the significant denomination of Algebusta. -Here in England, however, the vast increase of practitioners in the -art of surgery appears to have placed the old original Bone-setter in -the shade; and I myself in many instances, have heard this most useful -member of society designated as a mere quack; but most unjustly so, -because a quack is generally considered as one devoid of professional -education, and he is too apt to deal in spurious medicines. But not so -the Bone-setter, whose extensive and almost incessant practice makes -ample amends for the loss of anything that he might have acquired, by -attending a regular course of lectures, or by culling the essence of -abstruse and scientific publications. With him theory seems to be a -mere trifle. Practice—daily and assiduous practice—is what renders -him so successful in the most complicated cases. By the way in which -you put your foot to the ground, by the manner in which you handle -an object, the Bone-setter, through the mere faculty of his sight, -oftentimes without even touching the injured part, will tell you -where the ailment lies. Those only, who have personally experienced -the skill of the Bone-setter, can form a true estimation of his merit -in managing fractures and reducing dislocations. Further than this, -his services in the healing and restorative art would never be looked -at. This last is entirely the province of Galen and his numerous -family of practitioners. Wherefore, at the time that I unequivocally -avow to have the uttermost respect for the noble art of surgery in -all its ramifications, I venture to reserve to myself the following -(without any disparagement to the learned body of gentlemen who -profess it) sincere esteem for the old practitioners who do so much -for the public good amongst the lower orders, under the denomination -of British Bone-setters. Many people have complained to me of the -rude treatment they have experienced at the hands of the Bone-setter; -but let these complainants bear in mind, what has been undone by force -must be replaced by force; and that gentle and emollient applications, -although essentially necessary in the commencement, and also in the -continuation of the treatment, would ultimately be of no avail, without -the final application of actual force to the injured parts. Hence the -intolerable and excruciating pain on these occasions. The actual state -of the accident is to blame—not the operation. The thanks of every -Bone-setter is due to the eminent naturalist for his testimony of the -value of, and his vindication of, the art they practise. His own quoted -case is a peculiar one, but the experience of every Bone-setter could -furnish a parallel and even more surprising instances of cures effected -when the resources of scientific surgery have failed. - -Of the older Bone-setters we find some extraordinary accounts, and -evidently not penned by friendly hands. One of the most famous of the -Bone-setters of the last century was Mrs. Mapp, of Epsom, who was the -daughter of a Bone-setter named Wallin, of Hindon, Wiltshire. The -accounts of her life and career, which have come down to us, are very -contradictory. For instance, the _London Magazine_ tells us that in -August, 1736, the town was surprised with the fame of a young woman at -Epsom, who, though not very regular in her conduct (so it was said) -wrought such cures that seem miraculous in the Bone-setting way. The -concourse of people to Epsom on this occasion is incredible, and it -is reckoned she gets nearly 20 guineas a day, she executing what she -does in a very quick manner. She has strength enough to put in any -man’s shoulder without any assistance; and thus her strength makes -the following story the more probable. A man came to her, sent, as is -supposed by some surgeons, on purpose to try her skill, with his hand -bound up, and pretended his wrist was put out, which upon examination -she found to be false; but, to be even with him in his imposition, she -gave it a wrench which really put it out, and bade him _go to the fools -who sent him and get it set again_, or, if he would come to her that -day month, she would do it herself. It is further stated that since she -became famous she married one Mr. Hill Mapp, late servant to a mercer -on Ludgatehill who, it is said, soon left her and carried off £100 of -her money. Her professional success, however, says another account, -must have gone far to solace her for matrimonial failure. Besides -driving a profitable trade at home, she used to drive to town once a -week in a coach-and-four, and return again bearing away the crutches -of her patients as trophies of honour. She held her levees at the -“Grecian” Coffee House, where she operated successfully upon a niece -of Sir Hans Sloane. The same day she straightened the body of a man -whose back had stuck out two inches for nine years; and a gentleman who -went into the house with one shoe-heel six inches high came out again -cured of a lameness of twenty years standing, and with both his legs -of equal length. It does not appear that she was always so successful, -for one Thomas Barber, tallow-chandler, of Saffron-hill, thought proper -to publish a warning to her would-be patients. The cure of Sir Hans -Sloane’s niece made Mrs. Mapp town talk, and, if it was only known -that she intended to make one of the audience, the theatre favoured -with her presence, was crowded to excess. A comedy was announced at -the Lincoln’s Inn Fields Theatre, called _The Husband’s Relief; or the -Female Bone-setter, and the Worm Doctor_. Mrs. Mapp attended the first -night, and was gratified at hearing a song in her praise, of which we -give two verses as a specimen: - - You surgeons of London who puzzle your pates - To ride in your coaches and purchase estates; - Give over, for shame, for your pride has a fall, - And the doctress of Epsom has outdone you all. - - Dame Nature has given her a doctor’s degree, - She gets all the patients and pockets the fee; - So if you don’t instantly prove it a cheat, - She’ll loll in a chariot whilst you walk the street. - -Mrs. Mapp soon afterwards removed from Epsom to Pall Mall, but she -did not forget her country friends. She gave a plate of 10 guineas to -be run for at Epsom, and went to see the race. Singularly enough the -first heat was won by a mare called “Mrs. Mapp,” which so delighted -the doctress, that she gave the jockey a guinea, and promised to make -it a 100 if he won the plate, but to his chagrin he failed to do so. -The fair Bone-setter’s career was but a brief one. In 1736 she was at -the height of her prosperity, yet, strange to say, she died at the end -of 1737 in miserable circumstances, as set forth in a paragraph in the -_London Daily Post_ of December 22nd, 1737. The success and reputation -of Mrs. Mapp has met with a parallel in our own day. Just at the time -when Dr. Wharton Hood was showing the English surgeons how to imitate -the practice and cures of the Bone-setter, the medical journals gave -prominence to the doings and manipulation of a female Bone-setter named -Regina Dal Cin, who had astonished the surgical world both in Italy -and Austria. Dr. A. Joannides[1] describes her manipulations which he -witnessed in company with many hundreds of medical men and students -in the Ospedal Civico at Trieste. He says, “No case of reductions of -the femur were witnessed by me. Many cases of muscular rigidity of -the upper and lower extremities, and more especially of the small -articulations, have been either completely and instantaneously cured -or partially ameliorated. No attempt has been made in cases of old -dislocations with fistulas or scars.” Her doings excited some attention -even in this country. We are told that she was an intelligent looking -woman, about fifty-five years of age, and that she had practised -the art, which had been taught her by her mother and grandfather -for about forty years at a place named Vittoria, in the province of -Treviso. After the death of her mother, she joined her brother, who -kept a public-house, where she exercised her skill on the lame and the -crippled frequenters of the establishment, and effected a number of -cures. A medical eye witness tells us that her activity, flexibility, -and sensibility of the tips of her fingers, and her habit of -incessantly talking to the patient whilst operating, are the qualities -on which her success in operating depends. Gradually coming into notice -among persons of various classes of society, she obtained a wide spread -of reputation, and visited among other places, Venice, Trieste, Pesth, -and Vienna. In each place crowds of patients, both belonging to the -locality and coming from a distance flocked to her. She professed -especially to treat deformities of the hip joint, even reducing -dislocations of long standing, whether congenital or acquired. She -does not operate except in the presence of a surgeon. This, according -to one account of her, was a measure taken for her own safety, as she -was once interfered with by the Austrian law for practising without a -legal qualification. A Royal Commissary of the district of Vittoria, -however, gave her permission to practice the reduction of human joints, -and especially of femoral luxations, provided that she operated in the -presence of a physician. The _British Medical Journal_ devoted some -space to Regina Dal Cin’s method of procedure which shows that she -practised on similar grounds to the English Bone-setter, as detailed -in these pages. We are told by the journal in question she first -applies poultices for some days, for the purpose of softening the -tissues; this having been effected to her satisfaction, she operates -by rapidly performed process of manipulation. Professional opinion -was divided as to her merits. Her supporters alleged that her cures, -including the reduction of old dislocations, were genuine; that—as -Dr. Schivardi of Milan observes—“science ought to be grateful to -her for having amply demonstrated by a vast number of facts (1) that -dislocations even of long standing can be cured without recourse to -any great violence, or to the ponderous instruments hitherto deemed -indispensable; (2) that small and modest apparatus suffice, after the -operation, to keep the limb in its place—nay, are more efficacious -than strong instruments; (3) that quiet and absolute repose for eight -days, and moderate repose for other twenty days, suffices to enable -Nature to bring to the new domicile given to the head of the joint all -the materials necessary for the fabrication of the fresh ligaments -required.” On the other hand her opponents, more or less, denied her -cures, and considered her an impostor. Dr. Neudoorfer, apparently -admitting some of her cures of ankylosed hip-joint, states that -the method which she follows is nearly the same as the process of -“apolipsis,” recommended and practised by him several years ago, for -the removal of fibrous ankylosis. She paid a visit to Vienna, where -her proceedings attracted a good deal of attention, and gave rise, to -some degree, of controversy in medical circles. A specially appointed -committee accompanied her in her visits to four patients, and their -report was unfavourable to her pretensions, and resulted in the -withdrawal of the permission given to practice in Vienna. - -A few months prior to these experiments in Vienna, there died at -Watford, one of the best known bone-setters, Mr. Richard Hutton of -Watford, Herts. The _Lancet_ in recording his decease on January -6th, 1871, makes the following admission in a very different tone it -assumed barely two years before. It calls him a successful bone-setter, -for “successful he certainly was, and it were folly to deny it, in -some cases which had baffled the skill of the best surgeons; but -his failures were many, though these of course were little heard -of. Following the general practice of bone-setters he diagnosed a -dislocation, or several dislocations, in every case in which he -was consulted; and when, fortunately, the case was one of chronic -thickness about a joint, with possibly partial ankylosis or adhesion -of tendons, the greatest success attended his rough manipulations in -many instances. Every now and then Hutton got into difficulties by -attacking an acutely inflamed joint, or by lighting up mischief in an -old case; but as a rule he was too cautious thus to be caught out. -We have seen some of his successes and some of his failures, and the -redeeming feature about him was that though an empiric, he was not an -extortionate one, and in many cases refused remuneration altogether.” - -It was through this Mr. Hutton that the _Lancet_ was enabled to -publish a portion of the system practised by him, and which has been -since partly followed by the faculty; but even the _Lancet_, after -admitting the skill of the Bone-setters and their success, cannot -repress the habitual sneer at their successful and humble operations. -We have an instance of this, when recording the death in May, 1875, -of a celebrated Bone-setter, of the name of Burbidge, who died in -Frimley, Surrey, where local tradition ascribed numerous cures to his -manipulative skill. “We do not know” says the leading medical organ -“whether any _spells_ or _incantations_ were used at the ceremonies -in which he operated, as practised by some of his genus!” The writer -must have been dreaming of the medical practitioners in the time of the -Pharaohs when he penned this. Mr. Burbidge’s father and grandfather -were celebrated Bone-setters. - -Another famous and “good Bone-setter” is recorded by Mr. C. Waterton, -in his _Essays on Natural History_ before quoted: “About half a mile -from Wakefield’s Mammoth Prison, on the Halifax Road, nearly opposite -to a pretty Grecian summer-house, apparently neglected, resides Mr. -Joseph Crowther, the successful Bone-setter. He has passed the prime of -life, being now in his seventy-seventh year, but unfortunately he has -no son to succeed him. I might fill volumes with the recital of cases -which he has brought to a happy conclusion. Two in particular, dreadful -and hopeless to all appearance, have placed his wonderful abilities in -so positive a light before my eyes, that I consider him at the head -of his profession as a Bone-setter, and as a rectifier of the most -alarming dislocations which are perpetually occurring to man in his -laborious journey through this disastrous vale of tears.” - -The published accounts of voyagers and travellers are full of -anecdotes of those who practise “bone-setting” in different parts of -the world. There is a wonderful similarity in their modes of treatment -as thus detailed. An instance or two will suffice. Mons. C. S. Sonnini, -in his _Travels in Upper and Lower Egypt_, published, at the beginning -of this century, on his journey towards Abyssinia, was sent for in his -character as a physician to attend the second officer in command at -Miniet, who had broken his leg three days before. He found that the -leg had been set by a Copt, whose “curious” mode of treating the -case was thought worthy of chronicling by the traveller. “The patient,” -he tells us, “was laid on the ground without either mattress, bed, or -carpet, but merely on a bed of sand. His leg and thigh were extended -and fixed between stakes driven into the earth, which also supported -a small brick wall, raised on each side in such a manner that the -fractured limb was confined in a piece of mason work, where it was -to remain till the completion of the cure. In order to promote the -formation of the callus of the fracture, the doctor had made a sort of -cement, oil, and the white of eggs, which he every day applied to the -leg.” - -Friar Moulton gives a recipe of a similar kind to be applied whilst -the bone is “setting.” Cateron, in his _Travels in Algeria_, gives a -instance of the same mode of treatment. He writes, “On our return, I -called upon the Schiek, Lisaid-Mansor, I found him stretched on a couch -built of stonework, cemented with clay, covered only with a few rags, -and with a stone for a pillow. His leg surrounded with bandages and -herbs, was firmly tied up in and kept straight by a thick slip of bark. -His foot was immovably fixed to a stake, stuck in the ground. He is -obliged to remain in this condition until the bones are united. This -severe treatment is not unfrequently fatal, but, if the Arab has a good -constitution, and gangrene does not set in, he recovers with a limb -more or less straight. The poor Schiek was busy flipping off with a -handkerchief tied to a stick, the swarms of flies which were attracted -to his wound. At the foot of the couch was the Tebib or surgeon, -himself reciting incantations like his Egyptian predecessors, and -prayers over the broken limb. He appeared much put out by my entrance, -for the Arabs think that all Europeans understand medicine; but he was -re-assured when he saw I looked on without interfering.” - -There have been many, and are still Bone-setters of eminence in -different parts of the country, who are ready with their welcome and -useful services, when other Denhams cry out for “a good bone-setter.” -The benefits they have conferred in the past on the sufferers by -external violence will be indicated by the testimony of well-known -public personages in the next chapter. - -[Illustration: PLATE II.—DISLOCATIONS. - -1. Dislocated Finger. 2. Dislocated Thumb. 3. Dislocation of hand -and radius forwards. 4. Dislocation of radius and ulna forwards. 5. -Subglenoid dislocation of humerus. 6. Outward appearance of ditto. 7. -Subcoracoid dislocation of humerus. 8. Dislocation of radius forwards -(outward appearance).] - - - - -CHAPTER II. - -_THE TESTIMONY OF THE PUBLIC._ - - - “The simple energy of Truth needs no ambiguous - interpreters.”—_Euripides._ - -In answer to the frequent questions as to what special good -Bone-setters have done in their special calling I have thought it best -to let the relieved patients of others speak before my own. First, -because they are well-known. Their cases are indisputable, and they -show that Bone-setters understand their art. I have culled these -cases from various sources, all of which I have acknowledged as far -as possible. I have already quoted Mr. Charles Waterton’s opinion of -Bone-setters from his “_Wanderings of a Naturalist_.” I will now direct -attention to the cure he vouches for by the Yorkshire Bone-setters:— - -Before I close these memoranda, I have to describe another mishap of -a very dark complexion. Let me crave the reader’s leave to pen down a -few remarks on Bone-setting, practised by men called Bone-setters, who -on account of the extraordinary advance in the art of surgery, are not -now I fear, held in sufficient estimation amongst the higher orders of -society. - -Towards the close of the year 1850, I had reared a ladder, full seven -yards long, against a standard pear tree, and I mounted nearly to -the top of this ladder with a pruning knife in hand, in order that I -might correct an overgrown luxuriance in the tree. Suddenly the ladder -swerved in a lateral direction, I adhered to it manfully, myself -and the ladder coming simultaneously to the ground with astounding -velocity. In our fall I had just time to move my head in a direction -that it did not come in contact with the ground; still as it afterwards -turned out, there was a partial concussion of the brain; and added to -this, my whole side, from foot to shoulder, felt as though it had been -pounded in a mill. In the course of the afternoon I took blood from -my arm to the amount of thirty ounces, and followed the affair up the -next day with a strong aperient. I believe that, with these necessary -precautions, all would have gone right again (saving the arm) had not -a second misadventure followed shortly on the heels of the first; and -it was of so alarming a nature as to induce me to take thirty ounces -more of blood by the lancet. In order to accommodate the position of -my disabled arm. I had put on a Scotch plaid in lieu of my coat, and -in it I came to my dinner. One day the plaid having gone wrong on -the shoulder, I arose from the chair to rectify it, and the servant -supposing that I was about to retire, unluckily withdrew the chair, -unaware of this act on his part, I came backwards to the ground with an -awful shock, and this, no doubt, caused concussion of the brain to a -considerable amount. - -Symptoms of slowly approaching dissolution now became visible. Having -settled all affairs with my solicitor betwixt myself and the world, and -with my Father Confessor, betwixt myself and my Maker, nothing remained -but receive the final catastrophe with Christian resignation. But -though I lay insensible, with hiccups and _sub sultus ten dimon_, for -fifteen long hours, I at last opened my eyes, and gradually arose from -my expected ruin. - -I must now say a word or two of the externals damaged by the fall of -the ladder. Notwithstanding the best surgical skill, my arm showed the -appearance of stiff and withered deformity at the end of three months -from the accident. And now my general state of health was not as it -ought to be; for incessant pain prevented sleep, whilst food itself did -little good. But my slumbers were strangely affected. I was eternally -fighting wild beasts, with a club in one hand, the other being bound up -at my breast. Nine bull-dogs attacked me one night, on the high road, -some of them having the head of a crocodile. - -I had now serious thoughts of having the arm amputated. This operation -was fully resolved upon, when, luckily, the advice of my trusty -game-keeper, John Ogden, rendered it unnecessary. One morning, -“master,” said he to me, “I’m sure you’re going to the grave. You’ll -die to a certainty. Let me go for our old Bone-setter. He cured me, -long ago, and perhaps he can cure you. It was on the 25th of March, -then—alias Lady Day, which every Catholic in the universe knows is -solemn festival in the honor of the Blessed Virgin—that I had an -interview with Mr. Joseph Crowther, the well known Bone-setter, whose -family has exercised the art from father to son time out of mind.” On -viewing my poor remnant of an arm—“Your wrist,” said he, “is sorely -injured, a callus having formed betwixt the hand and the arm. The -elbow is out of joint and the shoulder somewhat driven forward. This -last affair will prevent your raising your arm to your head.” Melancholy -look out! “But can you cure me, doctor?” said I. “Yes,” replied he -firmly; “only let me have my own way.” “Then take the arm, and with -it elbow, wrist and shoulder. I here deliver them up to you; do what -you please with them. Pain is no consideration in this case, I dare -say I shall have enough of it.” “You will,” said he, emphatically. -This resolute bone-setter, whom I always compared to Chiron the -Centaur for his science and his strength, began his operations like a -man of business. In fourteen days, by means of potent embrocations, -stretching, pulling, twisting, and jerking, he forced the shoulder and -wrist to obey him and to perform their healthy movements. The elbow -was a complicated affair. It required greater exertions and greater -attention—in fact, it was a job for Hercules himself. Having done -the needful to it (secundum artem) for one-and-twenty days, he seemed -satisfied with the progress which he had made; and he said quite -coolly, “I’ll finish you off this afternoon.” At four o’clock _post -meridian_, his bandages, his plasters and his wadding having been -placed on the table in regular order, he doffed his coat, tucked his -shirt-sleeves above his elbows, and said that a glass of ale would do -him good. “Then I’ll have a glass of soda water with you,” said I, “and -we’ll drink each other’s health and success to the undertaking.” - -The remaining act was one of unmitigated severity, but it was -absolutely necessary. My sister Eliza, foreseeing what was to take -place, felt her spirits sinking and retired to her room. Her maid, Lucy -Barnes, bold as a little lioness, said she would see it out; whilst -Mr. Harrison, a fine young gentleman, who was on a visit to me (and -alas! is since dead in California), was ready in case of need. The bone -setter performed his part with resolution scarcely to be contemplated, -but which was really required under existing circumstances. - -Laying hold of the crippled arm just above the elbow with one hand, -and below with the other, he smashed to atoms by main force the callus -which had formed in the dislocated joint, the elbow itself cracking, -as if the interior parts of it had consisted of tobacco pipe shanks. -Having predetermined in my mind not to open my mouth, or to make any -stir during the operation, I remained passive and silent, whilst this -fierce elbow contest was raging. All being now effected as far as force -and skill were concerned, the remainder became a mere work of time. -So putting a five pound note by way of extra fee into this sturdy -operator’s hand, the binding up of the now rectified elbow-joint was -effected by him with a nicety and a knowledge truly astonishing. - -Health soon resumed her ancient right; sleep went hand-in-hand with a -quiet mind; life was once more worth enjoying; and here I am just now -sound as an acorn. - -Dr. Wharton Hood disparages the lucid statement and style of Mr. -Waterton, but does not gainsay his testimony or facts. - -The testimony of Mr. George Moore, the eminent philanthropist to the -skill of a “bone setter,” is duly recorded by Dr. Smiles, in the life -of the Cumberland Worthy and London Merchant.[2] Mr. Moore was very -fond of hunting, both as a recreation and as a means of health. “I -hunt,” he says, “not only for pleasure, but for my health. The -exercise does me great good. I really do not see any harm in a gallop -with the hounds; if I did I would not go out again.” He hesitates -and deliberates on the subject again and again. “I make my health my -excuse. The fresh crisp air does me good. I am always at home when on -horseback.” - -“In March, 1867,” says Dr. Smiles (pp. 292), “he met with an accident -which put a stop to his hunting.” The meet was at Torpendow. From -thence they went to the top of Binsey, a heathery fell, to the south of -Whitehall. There they found a fox, and viewed him away. Always anxious -to keep up with the hounds, Mr. Moore rode fast down the hill. But his -bay mare got her foot in a rabbit hole, and the rider got a regular -cropper. He found that his shoulder was stiff. Nevertheless, he mounted -again and galloped away. The hounds were in full cry. He kept up pretty -well, though his shoulder was severely hurt. - -Next day he entertained a dozen friends, amongst whom was the -master of the hunt and Frank Buckland. Nothing was talked about but -fox-hunting. “I think,” says Mr. Moore, “I must make yesterday my last -day’s hunting.” Shortly after he consulted a celebrated surgeon, at -Carlisle, about his shoulder. The joint was found “all right,” though -the muscles were pronounced strained and hurt. Nothing could be done -for the pain but to grin and hide it. - -He went to the Castle Compensation Meeting, at Carlisle, in which he -took an active part. Then he went to sit on the bench at Wigton, for -he was a Justice of the Peace for Cumberland. After that he had twenty -friends and relatives to tea and supper. “I hope,” he says, “that I -shall never forget my poor relations and friends.” - -Notwithstanding the intense pain in his shoulder, Mr. Moore continued -to hunt. The year after his shoulder had been dislocated, he invited -the Cumberland Hunt to meet at Whitehall. About sixty horsemen were -present. They breakfasted in the old hall and then proceeded to mount. -Mr. Moore was in low spirits because of the pain in his shoulder, -and at first he did not intend to join his friends. But Geering, his -coachman, urged him to go, and Sir Wilfred Lawson joined him in his -persuasions. At length Mr. Moore’s favorite horse, Zouave was brought -out, and with his arm in a sling and a cigar in his mouth he consented -to mount. Mrs. Moore and Lady Lawson ascended the tower and saw the -brilliant red coats ride away through the park. - -The array of horsemen passed on to Watch-hill and found a fox. He was -viewed away, and went across Whitehall-park, close under the wall of -the west-front garden, followed by the hounds and riders. It was a -sight not often to be seen. The day was splendid, although it was in -November. The sun was shining and the red coats, jumping hedges and -fences amidst green fields, brightened up the picture. The fox went -up the hill, out of sight of the gazers from the tower, and was lost -in Parkhouse covers. Again the hunt proceeded to Watch Hill and found -another fox. Away it went almost in the same direction, passing through -Whitehall Park with the hounds and hunters at its heels. There was a -slight check at Park-wood. Then it took straight away for Binsey, went -up the side of the hill, and passed on to Snittlegarth, and was lost at -Bewaldeth. - -It grew dark. No more could be done that night. No fox had been killed, -though the hunters had got a splendid run. Mr. Moore returned home with -his arm in his sling, though nothing the worse for his day’s exercise. -“It was,” he says, “a very enjoyable day. I do like a day’s hunting. I -always feel more light and buoyant after it.” It was his last hunt. - -The various surgeons to whom Mr. Moore applied did not give him any -relief from the pain he suffered in consequence of this accident. He -bore it throughout the year, 1868, during the time he was Prime-Warden -of the Fishmongers’ Company. - -Dr. Smiles says (pp. 318, 319)—“He had consulted the most eminent -surgeons. They could find no cure for the pain in his shoulder. Some -called it rheumatism, others neuralgia, some recommended a six months’ -sea voyage, others strapped up his shoulder with plasters and told -him to keep his arm in a sling. At length the pain became unbearable. -Sometimes the shoulder grew very black. The dislocation forward, which -it seems to have been, interrupted the circulation of the blood. Still -he continued to work on as before.” - -On the 7th December, 1868, he writes with difficulty in his diary—“I -was struck down with neuralgia at the Middlesex Hospital, when on a -committee for selecting a clergyman. I had my shoulder cut open to -insert morphia. I am _very_ bad!” - -He was taken home in a cab by the late Mr. De Morgan (surgeon). When -he entered the house he clung by a pillar as if he were drunk. He could -scarcely get up to his bedroom, and there he dozed and rambled; but -the pain was somewhat relieved. He called in one of the most eminent -surgeons in London, but, as Mr. Moore writes—“he did not understand my -shoulder.” Another surgeon was called in—and still another, but the -result was the same. It was with great difficulty he could attend the -consecration of his church in Somers’ Town, with his arm in a sling. -“The shoulder,” he says, “is not so black as formerly, but the pain is -more acute.” Then the first physician in London was called in.—“It is -a most painful affection of the shoulder-joint.” The patient already -knew that. But the physicians as well as the surgeons could do nothing -for him. - -He went about, though looking very ill, to the Field Lane Refuge—to -the Industrial Dwellings—to Christ’s Hospital—to the Court of the -Fishmongers. He even travelled down to York to stay a few days with -the Archbishop. On his return he attended a meeting of Christ’s -Hospital, “about a reform in the mode of education in the school.” A -few days later he says, “The neuralgia came on fearfully all day, and -at night I was in torture. Mrs. Moore rushed off in the brougham to -fetch Dr.——, that he might see my arm at the blackest. Still nothing -could be done. Then Mr.—— came and plastered and bandaged up my arm.” -The patient could not write; it was with difficulty that he could -sign a cheque. His wife then became his amanuensis. At a banquet at -the Fishmongers’, he was seized with one of his furious paroxysms of -neuralgia. A surgeon was sent for, who came and gave him chloroform. - -At length he could bear his pain no longer. He had been advised to -go to a well-known bone-setter. No! He would not do that. He had put -himself in the hands of the first surgeons of the day. Why should he go -to an irregular practitioner? At length, however, he was persuaded by -his friends. As the surgeons had done their best, why should he not try -the bone-setter? He called upon Mr. Hutton, at his house. He looked at -the shoulder. Well, he would try and put it in. This was new comfort. -Mr. Hutton recommended his patient to buy some neat’s-foot oil and rub -it in as hot as he could bear it. “Where can we buy the stuff?” asked -Mrs. Moore. “You can take a soda-water bottle and get it at a tripe -shop in Tottenham Court Road.” “We have not got a soda-water bottle -with us.” “You can get one at the corner at the public-house!—you -might get it at a druggist’s,” he continued, “but he will charge you -three times as dear.” The neat’s-foot oil was at last got; the shoulder -was duly rubbed with it; and the bone-setter arrived at Kensington -Palace Gardens to do his best or his worst. He made Mr. Moore sign a -paper before he proceeded with his operation, in which he agreed to -be satisfied whether failure or success was the result. Hutton took -the arm in his hand, gave it two or three turns, and then gave it a -tremendous twist round in the socket. The shoulder-joint was got in! -George Moore threw his arm out with strength straight, before him, and -said, “I could fight,” whereas, a moment before he could not raise it -two inches. It had been out for nearly two years. - -Mr. Moore was taken to task by his professional friends for going -to a quack about his shoulder. “Well,” said he, “quack or no quack, -he cured me, and that was all I wanted. Whereas, I was blind, now I -see.” After presenting a bust of Lord Brougham and a silver claret -jug to the Fishmongers’, in memory of his prime wardenship, he set -out for Whitehall on the following day and invited Mr. Hutton (the -bone-setter) to join him in Cumberland, as a token of his thanks to him -for having relieved his sufferings. The shoulder continued to improve. -When his benefactor Hutton, the bone-setter, arrived at Whitehall, he -gave him a hearty welcome, and sent him away rejoicing. Mr. Moore was -no more troubled with his shoulder. - -Hutton died soon afterwards, and Mr. Moore remarks in his diary that he -was as much struck by his unworldliness as by his skill, for he refused -to take any fee additional to the £5 that was at first asked. It was -with great pressure that Mr. Moore prevailed upon him to take £5 more. - -During his repeated accessions of pain he entered, or made Mrs. Moore -enter, many memoranda in his diary, of which we subjoin a few:— - -“We must wait until the day dawns, and the shadows flee away, to know -how wise and suitable every dealing of God is with us.” - -“I am ashamed to think that I sometimes doubt whether God hears my -prayers—they are so poor, so weak, so spiritless. I thank God my faith -is as simple as a child’s.” - -“I have sorrows to go through, but they will only prove joy afterwards. -Whom our Master loveth He chasteneth. No Cross no Crown. As I suffer so -I shall enjoy. Prayer is the mightiest influence men can use. Like the -dew in summer, it makes no noise. It is unseen, but produces immense -results.” - -“Exercise is the secret of a healthy body, and active working for -God is the secret of a healthy soul. He that watereth other shall be -watered himself.” - -[Illustration: Plate III.—DISLOCATIONS. - -9. Dislocation of radius backwards. 10. Dislocation of ulna backwards. -11. Dislocation of jaw. 12. Dislocation of hip outwards. -13. Dislocation of hip inwards.] - - - - -CHAPTER III. - -_THE TESTIMONY OF THE PUBLIC—continued._ - - - “All these are good, and these we must allow, - And these are everywhere in practise now.” - - _Taylor the Water-Poet._ - -The case related by Dr. Smiles is interesting to every Bone-setter, -as well as to the public at large, for it drew attention to the fact -that there existed a number of “specialists” who had made bone-setting -and sprains their study, who had inherited the experience of their -predecessors, and who, though not recognised by the “schools,” or -enrolled under the various acts for the registration of medical -practitioners, had done a vast amount of good and had alleviated -a great deal of pain which had baffled the _skill_ of the regular -surgeons. - -Dr. William Chambers, in the _Journal_ which bears his name, had -drawn attention to the case of Mr. George Moore, in a review of Dr. -Smiles’ book, which seems to have excited the indignation of several -surgeons, who “called in question the accuracy of the story.” To these -the editor, presumably Dr. Chambers himself, replies by quoting the -testimony of a number of correspondents who had favoured him with -their experiences. Dr. Chambers refers those who doubt the statement -about Mr. George Moore, to Dr. Smiles himself, whom he truly says “is -not given to romancing.” “We have,” he continues,[3] “ourselves, -however, known some curious instances of illiterate men who, by a sort -of natural tact, were eminently successful as bone-setters.” One of -these instances was that of a drummer in a militia regiment as long -ago as 1812, who, when discharged at the peace of 1815, set up as a -bone-setter, and made a living by his profession. Not long since, there -died an eminent bone-setter on Spey-side, to whom persons suffering -from dislocations flocked from all quarters. It seems ridiculous -to pooh-pooh instances of this kind. A wiser policy would consist -in finding out what were the special modes of operation of these -bone-setters, and taking a hint from them. - -While one correspondent has favoured us with his doubts on the subject -of unprofessional bone-setting, others have written to verify cases -such as that recorded by George Moore’s biographer. One of these -communications is as follows: ‘In 1865, I had met with a severe -accident on board a ship coming home from India, and among other -injuries the middle finger of my right hand was much injured. There -were two or three doctors among the passengers besides the ship’s -surgeon, and they all agreed that it was merely a severe bruise. I -thought little of it, hoping it would soon get right; but when six -weeks had passed and the finger was still quite powerless, I consulted -an excellent general practitioner in England, who said the joint was -enlarged, and recommended an application of iodine, which took off the -skin, but had no other effect. Two other surgeons—one of them a man -of considerable repute—were consulted, but with no better result; and -eventually I was persuaded to go to a bone-setter in Liverpool. The -moment he felt the finger he said “It’s dislocated.” The treatment -was very simple. The finger was enveloped in a bag of bran and kept -constantly wet for a fortnight, and then it was set. The operator gave -it a violent wrench. I heard a crack like that made when one pulls -one’s finger-joints sharply; and from that moment I had the full use of -my finger, which until then was absolutely powerless. The fee, as far -as I remember, was ten shillings, certainly not more. - -“The case which led me to consult this bone-setter was much more -remarkable. Among the passengers on board the same ship was an Indian -civilian who had been severely mauled by a tiger, in trying to save a -fellow-sportsman’s life, and had quite lost the use of one arm. He was -on his way home to see if anything could be done to restore it; and his -disappointment was great when, after some months’ treatment by one of -the greatest of London surgeons, there was hardly any improvement, and -no hope was held out of more than a very partial cure. While down in -Wales, he heard of the bone-setter above mentioned, who was a native of -the Principality, and determined to try his powers. In a few months, by -simple treatment and the wonderful power of manipulation which this man -possessed, the use of the arm was entirely restored, and has ever since -remained so.”’ - -The gentleman above alluded to was undoubtedly Mr. Evan Thomas, of -Crosshall Street, Liverpool, whose reputation and skill enabled him -to realise a handsome competence. The record of his cures, and the -instances in which he has given relief when regular surgeons have -failed, would fill a volume. A well-known actor on the London stage has -furnished several instances which fell under his personal knowledge. -Mr. Evan Thomas is now represented by a relative (a son I believe) who -has taken out a diploma as a surgeon, and is therefore a “bone-setter” -according to Act of Parliament. - -The writer of the above anecdotes expressly points out that he does -not for a moment wish to disparage the skill and care shewn by the -regularly qualified surgeons in ordinary and in many extraordinary -cases. They are with few exceptions, upright and generous men, and -their kindness and tenderness seem specially developed by the pain -which they so often have to inflict; but there are cases—more -frequent, I believe, than is commonly supposed—where something more -than training and practise is needed; and there are a few men (and -women too) who seem intuitively to possess this something—a gift of -touch which tells them when a joint, or it may be a muscle or tendon, -is not in its right place, and enables them to put it right. - -“It is this which I think the medical profession and the public -generally should recognise, instead of speaking of these bone-setters, -as is often done, as quacks, and their cures as fables, or at best -happy accidents. In some cases the possessors of this gift have taken -the necessary diploma which permits them to practise; in others they -have not the means or education which would enable them to do so; or -perhaps they have only discovered their gift comparatively late in -life, when they have settled down to other professions.” “Surely,” the -Editor remarks, “some means could be devised by which this gift, when -it is discovered in an individual, can be utilised for the benefit of -suffering humanity without the ordinary diploma, and yet with some -check which would prevent imposture. The first step is the recognition -that such a gift does exist; and then let it be the subject of -intelligent inquiry.” - -The next instance given in the _Journal_ before referred (pp. 712) -is contributed by a well-known clergyman of Northamptonshire, and is -a voluntary and unlooked for testimonial to the author. He writes as -follows:—“Some twelve years since, when returning from a visit to a -friend on a bitterly cold December evening, I unluckily slipped upon -a sheet of ice on the foot-path, and fell with my leg bent completely -under me. The pain was intense, and for a quarter of an hour I was -unable to raise myself up. Fortunately, I was not far from home, and -managed to crawl to my own door. For two or three subsequent days I -endured excruciating agony, and consulted my usual medical men in -the town of ——, who pronounced my injury to be a violent sprain of -the muscles of the knee, and after tightly bandaging the joint, they -recommended entire rest for some days. For six weeks I hardly moved -out-of-doors, and was quite unable, without assistance, to put on my -stockings and boots. - -“One day a neighbour suggested my seeing a celebrated bone-setter -who pays a weekly visit to this neighbourhood. I eagerly adopted -the suggestion, and by the aid of two sticks, attended by a friend, -I contrived to get into and out of the train, and reached the -bone-setter’s residence in due course. He first directed me to undress, -and placed a chair to rest my leg upon. After manipulating the limb, -he pressed my leg with such force that I fainted away, and when I -recovered my senses, the perspiration was literally streaming down my -face. I asked for some brandy, which he produced out of a cupboard -close by, remarking: ‘I always keep my physic here.’ - -“For some ten minutes afterwards I felt very faint and in great pain; -and without noticing his movements, he again suddenly pressed my leg, -causing me to faint away a second time; and when I came to, I found my -friend at my side whom I had left up-stairs, and who, startled by my -screams, had hastened down to see what was the matter. - -“The bone-setter then said: “Get up and walk; your knee was dislocated, -but you are now all right.” To my inexpressible joy I found my knee -replaced, and was able to walk as well as ever, and which for six weeks -I had been unable to do without the assistance of two sticks. For ten -years my leg was so well and strong, that I never needed the services -of the bone-setter. Unfortunately, about two years since, in pulling -off my boot I again dislocated the same knee, but in moving suddenly -in my chair to reach a book, the joint returned into the socket, like -the sharp report of a pistol. It has once since been out, but I have -managed to replace the joint myself; but I occasionally go to the -bone-setter to have the limb tightly plastered and bandaged, and over -the bandage I always wear an elastic knee-cap. - -“A neighbour of mine had a bad fall out hunting about two years ago, -and injured his shoulder, and for several weeks was unable to raise his -arm, and like myself, put himself under the charge of his usual medical -attendant. As the injury did not seem to abate, I advised him to go -to this same bone-setter, which he did, and in a very short period he -quite recovered the use of the limb, and is now able to drive and ride -as well as ever; the remedy he was ordered to adopt was hard friction, -night and morning, with rum and neat’s-foot oil. - -“I will mention an anecdote told me by this bone-setter. A poor -servant-girl who had been an in-patient of a neighbouring infirmary for -seventeen weeks, and had been discharged as incurable, consulted the -bone-setter, who discovered her ankle to be dislocated. With a violent -twist he replaced it, and she gladly left behind her, in his house, the -two crutches she had used for upwards of four months! - -“Although it seems almost incredible that regularly qualified surgeons -do not understand the art of bone-setting, or adopt their somewhat -rough usage, I believe they really dare not do so for fear of being -accused of rude treatment, by ladies or persons of sensitive feelings. -I believe the knack of bone-setting to be hereditary; at any rate it is -so in the case of my bone-setter (which is literally true), who is of -the third generation in this style of treatment.” - -The following is a case related by Dr. Wharton Hood, in his work on -“Bone-setting:”— - -“A gentleman, whom I will call Mr. A——, when sitting on a stool -at his office, hastily descended it to welcome a friend. As soon as -his feet reached the ground he turned his body without moving them, -and in so doing he twisted or wrenched his left knee. He immediately -felt considerable pain in the joint, which lasted for an hour or two, -but decreased as the day wore on, and he continued to move about as -occasion required. In the night he was aroused by increased pain, -and found the joint much swollen. Mr. A—— was the brother of the -professor of midwifery at one of the principal medical schools in -London, and he had the best surgical advice that London could afford. -He was ordered to rest the limb and to apply heat and moisture. In -this way he obtained some diminution of the pain, but the swelling -continued. He at last sent for Mr. Hutton, who at once declared that -the knee was “out,” and proposed to replace it. An appointment for -this purpose was made, but in the meantime the patient had again seen -eminent surgeons, and he wrote to prevent Mr. Hutton from coming. Two -years of uninterrupted surgical treatment passed without improvement, -and then Mr. A—— sent for Mr. Hutton again. On this the second visit -I accompanied him, and what I witnessed,” says Dr. Hood, “made a great -impression on my mind. We found the knee-joint enveloped in strapping; -and when this was removed, the joint was seen to be much swollen, -the skin shining and discoloured. The joint was immovable, and very -painful on the inner side. Mr. Hutton at once placed his thumb on a -point over the lower edge of the inner condyle of the femur, and the -patient shrank from the pressure and complained of great pain. He (Mr. -Hutton) made no further examination of the limb, but said: “What did I -tell you two years ago?” Mr. A—— replied: “You said my knee was out.” -“And I tell you so now,” was the rejoinder. “Can you put it in?” said -Mr. A——. “I can.” ‘Then be good enough to do so,’ said Mr. A——, -holding out his limb. Mr. Hutton. however, declined to operate for a -week; ordered the joint to be enveloped in linseed poultices and rubbed -with neat’s-foot oil, made an appointment, and took his leave. During -the dialogue I had carefully examined the limb, and satisfied myself -that there was no dislocation, and had arrived at the conclusion that -rest, and not movement, was the treatment required. At the expiration -of the week I went again to the house, and Mr. Hutton arrived shortly -afterwards. “How’s the knee?” was his inquiry. “It feels easier.” “Been -able to move it?” “No.” “Give it to me.” The leg was stretched out, and -Mr. Hutton stood in front of the patient, who hesitated, and lowered -his limb. “You are quite sure it is out, and you can put it right?” -There was a pause, and then: “Give me your leg, I say.” The patient -obeyed reluctantly, and slowly raised it to within Mr. Hutton’s reach. -He grasped it with both hands, round the calf, with the extended thumb -of the left hand pressing on the painful spot on the inner side of the -knee, and held the foot firmly by grasping the heel between his own -knees. The patient was told to sit steadily in his chair, and at that -moment I think he would have given a good deal to have regained control -over his limb. Mr. Hutton inclined his knees towards his right, thus -aiding in the movement of rotation which he impressed upon the leg with -his hands. He maintained firm pressure with his thumb on the painful -spot, and suddenly flexed the knee. The patient cried out with pain. -Mr. Hutton lowered the limb, and told him to stand up. He did so, and -at once declared he could move the leg better, and that the previously -painful spot was free from pain. He was ordered to take gentle daily -exercise, and his recovery was rapid and complete. In a few days -he returned to business, and from that time until his death, which -occurred three years afterwards, his knee remained perfectly well.” - -Another case was that of the Honourable Spencer Ponsonby, who is -suffered to tell his own story. “On November 26th, 1864, in running -across the garden at Croxteth, near Liverpool, I felt and heard -something crack in the calf of my left leg. It was so painful that I -rolled over like a shot rabbit, and could scarcely reach the house, a -few yards off. I at once put my leg up to the knee in a pail of hot -water, and boiled it for an hour. Next day, being no better, I sent -for a medical man in the neighbourhood, who told me I had snapped a -muscle, and must keep quiet for a few days. He rubbed in a strong -liniment, there being no sign of inflammation; and put on a strong -leather plaster. In a couple of days I was able to hobble; but being -telegraphed to London, and going into an empty house, I knocked my toe -against a tack in the floor, and hurt myself worse than ever. From -this time (December 2nd) to the beginning of May, I was attended by -Mr. A—— and Mr. B—— in consultation, who agreed in saying that the -“stocking of the calf was split” (gastrocnemius, I think they called -it) and treated me accordingly. Occasionally my leg got better; but the -slightest exertion produced pain and weakness. - -“On the 2nd of May, Mr. C—— undertook me. He agreed as to the injury, -but thought that, constitutionally, I was out of order, and gave me -some iron, &c., without effect. My leg was also fixed in an iron -machine to relieve the muscles of the calf from the weight of the leg. -Another eminent surgeon came in consultation on June 26. He agreed in -Mr. C——’s treatment, and in the cause of the lameness; as did Dr. -D——, who was consulted as to my going to Wildbad. - -“_August 14._—As I did not improve, Mr. C—— put my leg into a -gum-plaster for a month. I then went yachting, so as to obtain perfect -repose for that time. My health, which had been getting bad, was -improved by the sea-air, but my leg was no better. The surgeon on board -the yacht, Dr. E——, also examined me, and agreed as to the cause of -the lameness, but said: ‘An old woman may cure you, but no doctor will.’ - -“On September 7 the gum-plaster was removed, and galvanism was then -tried for about three weeks. At the end of this time I went on a yacht -voyage for four months, and, during the whole of this period had -sea-water douches. All this time I had been either on crutches or two -sticks. My health was much improved by the sea-voyage, but my leg was -the same as before, and had shrunk to about half its proper size. - -“_April 5._—Mr. F—— began his system to cure my leg. His idea -was, that the muscles were separated, but that if brought together -continuously, they would rejoin. I wore a high-heeled boot during the -day, and during the night my heel was fixed so that it was kept in the -same position. No good arose from this treatment; and consequently, -after a month’s trial, I went to Mr. Hutton, who, on seeing my high -heel, said: ‘What do you wear that machine for? Do you want to lame -yourself?’ I was proceeding to tell him the opinion of the various -surgeons on my case, when he said: ‘Don’t bother me about anatomy; I -know nothing about it; but I tell you your ankle is out, and that I can -put it in again.’ - -“After a few weeks, during which he had been to the North, and -could not therefore undertake my case, I returned to him on June -27, telling him that I had in the meantime consulted surgeons who -had assured me that, whatever else might ail me, my ankle was most -assuredly ‘all right,’ but that I would notwithstanding submit to -his treatment. He again examined me most carefully, beginning at the -ankle round bone, and he then put his thumb on to a place which hurt -me a good deal, and produced a sensation of a sharp prick of a pin. He -proceeded to operate upon me, and after a time there was a distinct -report, and from that moment the pain was gone. Mr. Hutton desired me -to walk moderately, but to take no violent exercise for a long time, -and to use a good deal of cold water. From that moment my leg gradually -got better. I was able to walk out shooting quietly in September, and -on the 14th October, having missed a train, walked home fifteen miles -along the high-road. In the following year I resumed cricket, tennis, -and other strong exercise, and have continued them ever since. - -In page 103 to 109 of his work before quoted, Dr. W. Hood relates -the experience of his father in treating of sprained ankles, in a -manner similar to that practised by the bone-setter, and illustrates -the system by these two typical cases, which, though by no means -extraordinary in their treatment and cure, have been thought worthy of -publication by him. Mr. J—— sprained his left ankle eighteen weeks -before coming under treatment. For the first month he laid on a sofa; -at the end of that time he was able to get about on crutches, and when -he presented himself for treatment was compelled to use a couple of -sticks. At no time since the injury had he been able to walk farther -than two or three hundred yards without resting. He complained of pain -on the inner side of the foot, and stiffness and pain in the great -toe when he attempted to use his foot. He was operated upon for the -purpose of replacing the bone of the foot, and overcoming the stiffness -of the toe. He returned home by rail the same day, and, on alighting -at the station walked half-a-mile slowly to his house. His powers of -locomotion steadily improved, and four days after the operation he -walked three miles. - -Mr. G—— came to Mr. H—— on the recommendation of Mr. J—— and -also was induced to do so from the benefit he saw that Mr. J—— had -derived from the treatment. In this case the ankle had been sprained -and bruised by a horse falling on him a year-and-a-half previous to his -visit to Mr. H——. Owing to the road along which he was riding having -been much cut up by cart wheels, his injury was much more severe than -would usually occur from this form of accident. When the horse fell -he was not thrown but went down with it; the injured foot touched the -ground, sinking into one of the ruts, when before he could withdraw it, -the animal rolled over, wrenching and bruising the limb most fearfully. -The foot was seen by Mr. H——, was still much swollen, and very stiff -in all parts. He was considered to have “five bones out” and the usual -manipulations were employed for their reduction. It required three -operations, at intervals of a week, before the stiffness of the foot -was removed, but at the end of three weeks he walked as well as he ever -did in his life. When he came he had his foot in a sling suspended from -his neck, so utterly useless was the limb. - -The advantage of the employment of movement a few days after the -receipt of the injury is shown, he says, by the history of one of the -cases that he saw with Mr. Hutton: - -J. F. (Stanmore) was thrown from a cart by the horse stumbling when -going down hill. He fell on his right shoulder and side of his head. -He remained stunned for about an hour; on coming to himself and trying -to raise with the assistance of the right arm, he found himself unable -to raise it, much less to bear any weight upon it. He succeeded with -great difficulty in getting into his cart (the horse it appears did -not fall completely and waited quietly at the side of the road) and -driving home. He suffered great pain all night, the arm being perfectly -useless, and the parts about the shoulder much swollen. He saw Mr. -H—— the following day and was directed by him to poultice and use -neat’s foot oil for a week. At the end of the week he was operated -upon. Increased pain followed the operation; it was not, however, in -the same spot, having shifted from the shoulder to the outer side of -the arm, near the insertion of the deltoid. No improvement in power -of movement occurred at the time; he could not raise his hand to his -head or bend his forearm. On his next visit, three days afterwards, -he said that the pain continued through the night, that he dropped -off to sleep towards morning, and when he awoke he found that it had -materially abated, and his sufferings had been comparatively slight -since. The swelling had diminished, but the motions of the joint were -not much freer. - -At the expiration of a week from the time of the operation, he appeared -again; and he could then place his hand behind his head and also on -the opposite shoulder. “With the exception of a slight stiffness, he -considered his limb quite well.” - -Yet two other cases from the same source:— - -Mrs. J——, on rising from her chair one day in 1864 caught her heel -in her crinoline, and fell backwards upon her sacrum. She did not feel -much pain from the fall at the moment although she felt a good deal -shaken. At this period she had been six weeks pregnant. On the fifth -day from the date of the accident, having in the meantime, without any -definite cause of complaint, been “out of sorts,” she noticed a feeling -of stiffness and numbness extending over the whole of the body, but -more especially in the extremities. Shortly after this occurred she was -seized with convulsions of an epileptiform character. These convulsions -they recurred at varying intervals of sometimes three or four days, -and at other times of ten days or a fortnight, until her confinement. -After this event she was subject to them, but at longer intervals until -October, 1869. Their increased frequency about this time induced her to -consult Mr. Hutton, both she and her friends considering that, as she -had never had any affection of this description previous to her fall, -the blow on her back might fairly be looked upon as the cause of her -trouble. A very tender spot was complained of at the junction of the -last lumbar vertebra with the sacrum. The sensations which preceded -the commencement of the fit were referred to that spot and the opinion -given by Mr. Hutton was that a bone was “out” there. On the three or -four days preceding his visit she had many severe convulsions; she was -suffering from exhaustion consequent upon them and fully expected to be -obliged to remain in bed some days to recover herself. She describes -herself as suffering at the same time from head-ache and fullness; her -back was very painful; she was flushed in the face, very depressed in -spirits, her eyesight was dim and she was very faint. - -When operated upon in the manner, hereafter to be described, she -felt “a sudden feeling of numbness of the brain,” this feeling -travelling upwards from the spot where the pressure was applied, and -then immediately following this a sensation which made her say “I am -all right.” In a minute or two she got into bed without assistance, -lay down on her left side—a position she had not been able to take -before—her color became natural, her head felt as if a weight had been -removed from it, the dimness of sight disappeared, and a difficulty of -raising the lids previously had gone. She remained in bed two hours, -and then was able to be dressed and go down stairs. She had no return -of the fits and had been quite free from them up to October, 1870. - -The other case mentioned by Dr. Hood is given in the words of the -patient, who states— - -“In July, 1859, I was playing in the garden with my children, when one -of them tossed a large indiarubber ball into the adjoining garden, -which was separated from my own by a stone wall about six feet high. -I procured a pair of steps and got over the wall; and coming back I -sat for a few minutes on the top of the wall, and then jumped down, -alighting upon the gravel walk. I felt no ill effects from the jump at -that time, but, awaking early nest morning I found my left leg very -stiff, and supposing this would pass off I went to business as usual; -but on walking I experienced pain on the inside of the knee joint, -which increased during the day, and at night I could scarcely walk. - -“The next morning I sent for my medical man (Mr. A——) who after -examining the knee pronounced the injury to be external to the joint, -and I think he said some cartilage had been strained. He ordered me -to pump cold water on it, which I did for several days; but the pain -increased and the knee began to swell. Mr. A—— then ordered leeches -to be applied, and afterwards a large blister enveloping the knee. - -After this the leg became very rigid at the joint, and flexed so -that the heel would not touch the ground, and I could only move from -one room to another by the help of crutches. After about two months’ -confinement to the house my appetite failed and I became very unwell. -I then saw another surgeon (Mr. B——) who thought that there was -something forming in the joint, but that my general health was failing, -and that I ought to have change of air, so by his and Mr. A——’s -advice I went to the sea-side where I remained until November. - -“Whilst there I applied sea-weed poultices, and bathed my knee in warm -sea water; but was soon obliged to discontinue this treatment as it -greatly irritated the joint, which became so tender and painful that -I could not bear the weight of the sheet upon it as I lay in bed. The -flesh of my thigh began to waste away at this time, and I lost -power in my left arm, thumb, and forefinger; so that for some time I -was unable to use a fork at meals. I called in a local practitioner -(Mr. C——) who gave me medicine; but as he said the pain in the knee -was of secondary importance, he did not prescribe for it. I took -exercise occasionally in an invalid chair, but, owing to the difficulty -of getting down stairs and the vibration of the chair itself, this did -me more harm than good. - -“I returned home in November, and passed the winter with very little -improvement; and having purchased a very easy invalid carriage with -shafts for a donkey, went out when the weather permitted. - -I continued to apply iodine and kept wet cloths constantly upon the -limb to keep down inflammation, and this treatment succeeded in a -measure, but only so long as I kept the leg at rest; for on making the -smallest attempt to use it the inflammation returned. - -In the spring of 1860 it was thought advisable I should consult Sir -B. Brodie, and my medical man (Mr. A——) went with me to London; but -finding that Sir Benjamin was out of town he took me to Mr. D——, -who affected to treat the matter very lightly, and said that I was to -take a tonic, which he prescribed, and that as my health improved my -knee would get well. He also sent me to a surgical bandage maker, who -measured me for a knee cap which was to enable me to walk and take more -exercise than I had hitherto done. - -This knee cap I was however unable to wear, until some months later, -when, the inflammation having subsided, I found it gave me some -support; but I was never able to wear it without much discomfort. -Up to October 1865 (a period of six years and a quarter) I used -crutches—sometimes two, at other times one crutch and a stout stick -and was never at ease, the knee always stone cold when in bed or -otherwise resting, and hot after exertion of any kind—the pain -becoming acute whenever I attempted to use the limb beyond just -crossing the room. During this period (six years) I spent a portion of -every summer at the seaside, and was withdrawn almost entirely from -business. At length after so long a course of treatment, I ceased to -seek further advice, believing what I was told, that the cause of all -my suffering was constitutional, and I settled down to the conclusion -that I should be a cripple for life and that this was unavoidable. - -“In June, 1865, I was recommended by a friend to consult Mr. Hutton, -but when I had learned he was an irregular practitioner, I declined; -and it was not until October, when, owing to an accidental stumble -against the door-sill, I was in much pain again, that I acceded to the -earnest solicitations of my friends. I then wrote to him and made an -appointment. At the first interview he came to me in the waiting-room -and, looking me hard in the face, he said, ‘who sent you here?’ I told -him who it was that recommended me to him. He said, ‘Do you know that -I am not a regular surgeon?’ I answered, ‘Yes.’ ‘Well, then, what’s -the matter with you?’ I told him I was lame. ‘Are those your sticks?’ -pointing to the crutches. ‘Yes.’ ‘Well, let me look at your leg.’ He -then instantly placed his thumb on the tender spot inside the knee, -causing me great pain. I said, ‘Yes, that is the place, and no other.’ -‘Ah!’ he replied, ‘I thought so. That will do. How long have you been -lame?’ ‘Six years.’ ‘What treatment have you had?’ I told him, and -also that my lameness resulted from constitutional causes. He said, -‘Bah! If you had not had a pretty good constitution they would have -killed you.’ I told him that I had seen Mr. D——. ‘Well,’ he said, -‘You might as well have seen my cook. He can’t cure that knee.’ I asked -him what he thought was the matter with it. He said, ‘That knee is out; -I’ll stake my reputation upon it, and I can cure it.’ I was ordered to -apply linseed meal poultices for a week, and then go to him again, and -happily with the best results. I have never needed the use of crutches -since, and although it was some time before I gained much strength in -the leg, I am now able to walk as well as before the injury. I forgot -to mention that before leaving Mr. Hutton’s house I walked up a flight -of stairs and down again, a feat I had not accomplished for years.” - -As a contribution to the patient’s point of view, and as a pendant -to some remarks made in the course of the preceding pages, Dr. Hood -thought it desirable to print a portion of the letter that accompanied -the narrative:— - - “_May, 1871._ - - “MY DEAR SIR,—In my communication I have confined myself to a - relation of facts only, abstaining from all comment, - but I should now like to say that I think you are doing great - service to the public in bringing the subject of (so-called) - bone-setting prominently before the profession, so as to - induce them to give it a measure of attention, instead - of pooh-poohing it, as has been their almost invariable - practice hitherto. In my own case, after submitting to Mr. - Hutton’s manipulation, I was instantly relieved from that - pain, tension, and coldness in the joint that I had suffered - for six years, and was able to walk. This recovery, which - to myself and friends seemed little short of a miracle, was - thus accounted for by the faculty:—Mr. A—— (whose patient - I had been) on the subject being mentioned to him, laughed, - and said, with a significant shrug, ‘Yes, yes! a nervous - knee! we all know what nervous knees are! ay! ay!’ Mr. B——, - who, as a friend, had seen my knee frequently (though not - professionally) assured all who mentioned the case to him that - I might have walked twelve months earlier had I cared to do - so. Other medical men accounted for the manifest change in my - condition on one hypothesis and another, whilst all affected - to smile at my ignorance and delusion. - - “Thus much as to the profession, but what were my own thoughts - and those of my friends and the public generally? I was like - the man spoken of in the Gospels, who had been blind, and now - could see I had been lame and in pain, but could now walk and - was at ease. I cared nothing for professional sneers as to - nervous or not nervous; and had the whole College of Surgeons - clearly demonstrated to their entire satisfaction that I could - not possibly have been benefitted by Mr. Hutton’s treatment, - my opinion would not have been shaken by it. - - “Then as to the public: my case having been well known my - recovery was quickly noised abroad, and a number of people - in the neighbourhood who had suffered many things of many - physicians and were nothing bettered, but rather grew worse, - sought Mr. Hutton’s advice, and were cured; and this has - happened in so many instances that public confidence in the - ability of the regular practitioner to deal with this class of - cases has been greatly shaken. I cannot better illustrate this - than by relating the following case:— - - “One Thursday morning last autumn a man came to me, and, on - my inquiring his business, he told me he wanted my advice. - He was a laborer in a factory who in lifting a weight, had - twisted his knee which was much swollen and painful when he - walked. I asked him what advice he had had. He said he had - been under the doctors’ hands some time, but the leg was worse - and he was now ordered to lay up entirely for a month, and - was assured that unless he did so he would lose his leg. In - one hand he held a medical certificate to entitle him (being - unable to work) to go on his club; in the other he had a large - lump of dark paste, about the size of an egg, which he said - was a blister, and which he was ordered to apply to the joint - immediately and to rest at home until the doctor called on him - the next day. I examined his knee, and from the similarity - of his symptoms to those I had myself experienced, I felt - satisfied his was a case for Mr. Hutton and I told him so. He - immediately told me he had heard of my case and so many others - that _he would rather take my advice than the doctor’s_. I - explained to him that he could not follow the advice of both, - and if he decided on going to Mr. Hutton he must on no account - apply the blister. To this he assented. The doctor’s assistant - called on him the next day, and was very angry that he had not - done as he was ordered, and then left, threatening to return - with his master, who he said would make him put the blister - on whether he liked it or not. This threat however, was not - carried out, and on Monday morning he went to Mr. Hutton with - several other patients who were going up on a similar errand. - He did not return until the last train at night, and I learned - next morning that, after visiting Mr. Hutton, he walked - several miles to see a friend and then back to the railway - station; he rested the next day, and on Wednesday returned to - his work, and has been quite well ever since. - - “The sentence in italics is one to which I desire to call - particular attention, since it gives expression to a feeling - of want of confidence in the profession, which I know to - be widely, though often secretly, entertained in this - neighborhood. - - “Would it not, then, be to the interest of the profession to - examine into these cases and not obstinately to close their - eyes to facts, which, but for professional prejudice, would - not fail to see as clearly, and reason upon as logically as - common people do. - - “I am, my dear sir, - - “Yours very truly, - - -The publication of Dr. Wharton’s book, added to the published testimony -of so many patients, awakened the “faculty” to the knowledge that -after all there was something more than luck in the Bone-setter’s art. -The change of tone was however gradual, with occasional relapses -into the old line of thought, not by any means without misgiving. -When professional attention was publicly drawn to the subject many -instances came to light which showed that Bone-setters proceeded on -true scientific which were neglected by, if not unknown to the faculty -at large. As frequently happens the earliest instance of professional -adoption of the art of the “Bone-setter” occurred in America. After the -publication of Dr. Hood’s work. A correspondent of _Nature_[4] seeing -a review of the work wrote to describe an accident he met with, the -failure of the surgeons at New York to cure him, and his subsequent -cure by one he calls “a scientific Bone-setter” who, of course, was -not an “empiric,” though he adopted the practise of the Bone-setter’s -art. The correspondent in question, Mr. Joseph P. Thompson, who dates -from Berlin, May 22nd, states that more than _twenty_ years ago in the -city of New York, while swinging upon parallel bars in the gymnasium -fell backwards, and to save his head threw out his left arm, thus -catching the fall upon the palmar head of the radius, and as it proved -fracturing the head of the radius at the point of articulation with -the ulna. I sent for one of the most eminent surgeons (then professor -and surgeon) to a large hospital, but several hours elapsed before his -arrival, and by that time the swelling and inflammation of the elbow -had all the appearance of a sprain, and the fracture was not detected. -Some days afterwards the surgeon found out that there had been a -fracture, and that a false adhesion had begun. This was broken up, and -the arm set in splints, according to the approved method. After -the usual time the bandages were removed, but the forearm was incapable -of flexion, extension, or rotation. Every appliance was used to restore -it to its normal condition, such as lifting, friction, sponging, &c., -but without effect. The arm became useless, and began to shrivel. It -was examined by the first surgeons in New York and other cities. Some -thought that the radius had adhered to the ulna, others that it was a -deposit of interosseous matter, but none could suggest a remedy. It -was some nine months after this, Mr Thompson goes on to say, that he -chanced to be in Philadelphia, and called upon Dr. Klea Barton, who, -though he had retired from practice, consented to look into the case. -After a careful examination he said, ‘If you will consent to suffer the -pain, (it was before the use of chloroform) I will agree to restore the -arm.’ He went on to say that pressure demonstrated a slight crepitation -at the joint, and also a slight elasticity; and this assured him -that the trouble was in the ligaments; that in consequence of the -long imprisonment of the arm in splints, while under inflammation, -a ligamentous adhesion had taken place, and the synovial fluid had -been absorbed. He then applied one hand firmly to the elbow, and the -other to the palmar end of the radius, and diverting my attention by -anecdote and wit, thus relaxing the resistance of the will to pain, -he gave a sudden wrench, there was a sound like the ripping of cotton -cloth, and the arm lay outstretched before me, quivering with pain, -but capable of motion. Mechanical appliances for a few weeks, so far -completed the restoration that I have ever since had about four-fifths -of its normal use and power.” - -Here was evidently an instance of manipulation, which, if done by -a bone-setter, would be called empirical, but as it was performed -by a retired surgeon, it was “scientific.” If the benefit is the -same, why this difference of designation? Let the “faculty” reply in -person—“What in the captain is but a choleric word; in the soldier is -rank blasphemy.” - - - - -CHAPTER IV. - -_THE TESTIMONY OF THE FACULTY._ - - - “What in the captain but a choleric word is in the soldier - rank blasphemy.” - -The first volume of the British Medical Journal for 1867 opens with a -report of a Lecture delivered by Mr., now Sir James Paget, Bart., on -“Cases that Bone-setters cure.” The Lecture is the first recognition -as far as I am aware that the profession of the Bone-setters received -at the hands of a professional surgeon, or qualified medical man, -anything more than the opprobrium of being a “quack,” an empiric, or -a charlatan. Ignorance, presumption, want of skill and knowledge were -laid to the charge of the Bone-setter. His success, if success, as -it admittedly did, attend his efforts to alleviate the anguish of a -sprain, to reduce a fracture or a dislocation, was attributed to a -happy accident, or “luck,” whilst any failure, or any mistake, -as if failures and mistakes were never made by those whose names -were duly printed in the _Medical Register_, was trumpeted always in -the medical journals and in the private coteries frequented by the -local doctors who happened to hear of the case. The many cures were -pooh-poohed, only the failures were deemed worthy of publicity. It -appears to have been forgotten that not many years have elapsed since -the barber-chirurgeons were the only recognised professors of surgery. -That the present scientific system of surgery is of comparatively -recent date. That there are instances on record of both physicians and -surgeons being tabooed and denounced because they had wandered from the -beaten path and had found out modes of curing disease and alleviating -suffering which were not known before, or at least only to a few. The -host of appliances and new methods of treatment are in the opinion -of many old and experienced medical men decidedly unnecessary. They -lead the student and the practitioner to disregard the empirical—the -practical—manual part of his art—to trust to a mechanical system and -not to himself, or to his personal skill and his experience. No one -can read Sir James Paget’s lecture without feeling that throughout -his address he was touching a subject that had only been brought under -his notice in the course of his professional career, and that only -in a partial manner. If anyone dissents from this view he has only -to compare the original report of the lecture in the journal I have -mentioned with the revised lecture and notes, edited by Mr. Howard -Marsh, and published more than twelve years after the lecture had been -first delivered. During that period, a great change had come over -the surgical world with respect to the much despised Bone-setters. -The greater publicity given to the cures of the Bone-setters by -independent men of mark, who had found their pains alleviated and their -afflictions cured by the professional Bone-setter, boldly stating their -experiences, told the faculty there must be something more in this -system of “quackery,” than was “dreamt of in their philosophy.” It was -evident, that however distasteful it might be, it must be treated with -respect, even if it jarred with their previously expressed opinions and -shocked their ideas of strict professional etiquette. - -[Illustration: PLATE IV.—DISLOCATIONS. - -14. Dislocation of shoulder joint. 15. Dislocation of foot inwards. -16. Dislocation of foot backwards. 17. Dislocation of tibia and fibula -forwards. 18. Dislocation of ulna and radius backwards.] - -No Bone-setter can find fault with Sir James Paget’s lecture beyond his -vulgarising, if I may so term it, his opening illustration. Such an -instance might occur, for there are “Bone-setters and Bone-setters.” -The term is doubtless assumed by many whose practice brings disgrace -upon those who pursue an honorable calling, even if they do not belong -to a chartered society, or are recognised by Act of Parliament and -therefore not “legally qualified practitioners,” it is true that they -are qualified by long experience, by early training, and the skill -gained by the constant practice of many years, but the law does not -recognise them. - -Sir James Paget appears to imagine that all the formula of a -Bone-setter is to say that “a bone is out,” and to use a wrench to -put it in again, which wrench he admits does good in some cases. -He admits “of course they have a certain number of real fractures -and dislocations which they reduce, and of old ankylosis which they -loosen.” “Of these,” he adds, “I need say nothing; for I believe there -is nothing in their practice in these cases which is not as well or -better done by regular surgical men.” - -He instances what he calls the “rare accident” of the slipping of a -tendon which a wrench may cure, and he is polite enough to say “I can -hardly doubt that a Bone-setter has occasionally done unwittingly, -a lucky trick, when, with wrenchings and twistings of a joint, he -has made some dislodged tendon slip back into its place.” Sir James -further enumerates a series of cases of injuries to joints, which -may, and indeed are, daily cured by Bone-setters, and he shows how -sometimes patients themselves may unlock a stiff knee whether caused -by loose cartilages, a stiffness of the muscles, or from other -causes. “It may be admitted generally,” he tells his audience, “that -from paying particular attention to this class of cases, which are -constantly occuring, that the Bone-setters have achieved their great -reputation where eminent surgeons have failed.” Sir James too dwells -on suppositious cases, which if treated by the Bone-setter’s wrench -would certainly end in mischief, and alludes to bad boys who simulate -stiff joints who often “escape disgrace by lying and letting the -Bone-setter be believed when he professes that he has ‘put in’ their -dislocations.” “Amongst all these cases of muscular difficulty,” Sir -James says, “there is a good harvest for Bone-setters and without doubt -their remedy is rough as it is real.” “But,” he continues, “there is yet -a larger class of cases which Bone-setters sometimes succeed in curing -very quickly, namely, ordinary sprains.” “I cannot doubt,” he says, -“that some recently sprained joints may be quickly cured, freed from -pain, and restored to useful power, by gradually increased violence of -rubbing and moving.” He admits that this has sometimes been introduced -into regular surgery, but, he goes on to state, that it is in cases -where old sprains have remained long uncured that Bone-setters, and -especially those who combine rubbing and shampooing with their setting, -gain their chief repute. He, therefore, cautions the surgeons against -giving too much rest, to avoid cold joints, excessive exercise, and try -more gentle methods than are popularly attributed to the Bone-setter, -as if the latter gloated over causing pain, which is not the case, -though he often thinks that one sharp pang is better than days of -agony, and, when over, his patient always coincides with him. The great -Master-Surgeon also points out that what are called “hysterical joints” -afford a rare opportunity for a victory for a Bone-setter, which may be -cured by sheer audacity of being pulled about. - -“From this you may see,” says Sir James, “that the cases that the -Bone-setters may cure are not a few, but,” he continues, “the _lessons -which you may learn from their practice are plain and useful_. Many -more cases of injured joints than one commonly supposed to be thus -curable may be successfully treated with rough movements.” - -“Learn, then, to imitate what is good, and avoid what is bad in the -practice of Bone-setters; and if you would still further observe the -rule, _Fas est ab hoste doceri_, which in no calling is wiser than -in ours, learn next what you can from the practice of rubbers and -plasterers; for these know many clever tricks; and if they had but -educated brains to guide their strong and pliant hands, they might be -most skilful curers of bad joints, and of many other hindrances of -locomotion.” - -Such is in brief the testimony of the great Master-Surgeon of the -age to the methods of practice adopted by the Bone-setters, who have -practised their art as their fathers and grandfathers have done before -them. His testimony at least shows that the Bone-setter works on truly -scientific grounds, and that he is not a mere “lucky trickster,” -a charlatan who works on the credulity of the public for the sake -of gain, pretending to cure others by his own conceit. As I have -before pointed out, Sir James Paget himself had occasion to modify -his originally expressed opinion when the process and mode of cure -practised by the late Mr. Richard Hutton was explained by Dr. Wharton -Hood. - -To this gentleman the profession and the public were indebted for -the first published authoritative account of the Bone-setter’s -art. There are but few Bone-setters who will say that Dr. Hood has -exhausted the subject, for he has not; he has only indicated a few -salient points, in which the practice of Mr. Hutton varied materially -from that taught in surgical schools. He showed that more might be -done in the surgical world by the leverage of the limbs, than by the -employment of complicated and expensive apparatus. He bemoaned the -“cost and loss” which the practitioners of surgery have sustained by -the resort of patients, affected by impaired mobility or usefulness of -limbs, after disease or injury to the Bone-setters, who so frequently -give relief and speedily cure a patient by their manipulations and -treatment. It is but just to Dr. Hood to say that he has given a -number of cases illustrative of his statements, which the faculty have -“condescended” to notice, and some of which, in my desire to give the -widest illustrations of the usefulness of the Bone-setter’s art, I -have embodied in this treatise. He dwells somewhat on the supposition -that all Bone-setters declare that “a bone is out” in every case of -thickened or stiff joint that is brought to them, but he seems to -forget that these are only a fraction of the “cases which Bone-setters -cure,” and on which our reputation so securely rests. The quarry men -of North Wales, as detailed in the _British Medical Journal_, in 1875, -preferred Mr. Thomas Evans, of Pen-y-groes, to their old regular -medical practitioner in cases of external injury to body or limb, -and though the profession were indignant at any medical men, being -associated with a mere Bone-setter in the rules of Friendly Society or -Sick Club, the connection is not unfrequent. The faculty have evidently -much to learn ere they can successfully compete with Bone-setters -in the special cases to which they devote their time, abilities and -attention. The patients are the best judges of results, and by results -the surgeon must be judged. Their case is not helped by detailing how a -Chinese farrier killed a girl the Emperor desired to marry, by forcibly -straightening her hump-back, as recorded in page 900 of the _Lancet_ -for 1872. It is far better for them to admit as Dr. G. Reed admitted -in the same journal that he “had his eye wiped” by a Bone-setter, at -Liverpool, who cured a sailor whom he failed to relieve. - -Throughout the medical publications from 1871 to 1880, there are -frequent allusions to the bone-setter and several admissions by -surgical practitioners,[5] that they have followed the method of -the bone-setter with success, and discarded therefore the teaching -of the schools; for though the _Lancet_ itself welcomed Dr. Wharton -Hood’s exposition of the art of the Bone-setter, as tending “to -afford the means for the suppression of a widely prevalent and _very -mischievous_ form of quackery which has been based, as every _success_ -of the kind must be upon some _neglected_ or _forgotten_ truth. The -late Mr. Hutton, on whose practise, Dr. Wharton Hood’s papers are -founded, was for many years a sort of bugbear to not a few of the most -distinguished surgeons of London, and every few months some fresh case -was heard of in which he had given immediate relief and speedy cure -to a patient who seemed vainly to have exhausted the legitimate skill -of the metropolis.” This is an admission somewhat at variance with -its previous utterances, and not as frank as the organ of a boasted -liberal profession should be, and is far from generous, for its tone is -embittered. - -It however goes on to say, that “in some country places and especially -in mining districts, in which large labouring populations are much -exposed to chances of injury, bone-setters become formidable opponents -to regular practitioners, and, like their London representative, -have their surprising cures to boast. It is true that they often -inflict injury; but this is not the aspect of the case to which our -attention should be first directed. They are not valued because they -do harm, but because they do a certain amount of good; and the way -in which this good is brought about is the matter of chief interest -to the profession.” The _Lancet_ goes on to say “that quackery is -only an expression of the extent to which legitimate practitioners -fail to meet the desires of the sick,” and then somewhat unfairly and -unjustly introduces the quack who pretends to cure phthisis or other -mortal illness, as if Bone-setters professed impossibilities. After -this inconsistent divergence it points out “that in the particular -in question (the art of the Bone-setter) it is incontestible that a -large number of irritable and useless joints have been restored to a -natural condition by Bone-setters after a long period of unavailing -surgical treatment, and that the profession has not known how this -desirable result has been produced, or what has been the true nature -of the lesion treated. The quack always said that a bone was “out” and -that he had replaced it, and the doctor knew quite well that these -statements were not correct. The doctor would not meet the quack; and -the quack kept his methods secret, and would not show them to the -doctor. The quack obtained more credit for a cure after the doctor had -failed, than the doctor for a hundred cures in an ordinary course; and -the Bone-setter, of all quacks was the one who did most to injure the -reputation of the profession. - -We once heard a military man of considerable distinction describe how -his son was instantly cured of a sprained knee by Hutton, after a -distinguished hospital surgeon had treated him to no purpose; and the -speaker wound up with the remark ‘you doctors are all duffers.’ - - * * * * * - -“At all events, for good or evil, the treatment pursued by Bone-setters -will now be fairly before the profession and scientifically educated -surgeons will soon be in a position to define accurately its merits, -its dangers, and the limitations of its usefulness. Its application by -ignorant men to unsuitable cases has often been followed by injurious -consequences; but no such consequences ought to occur in the hands of -the profession. We have little doubt that Dr. Wharton Hood has really -called attention to a neglected corner of the domain of surgery, to -morbid conditions that have been only very faintly described in books, -and scarcely at all recognised in practice, to precautions that have -been either unfounded or exaggerated, and to a method of cure at once -simple and intelligible. We hope to see as the result of his labour, -that the art of the Bone-setters will become extinct, after having -been for a time exercised only upon those cases for which treatment by -movement would be really unsuitable, and, as a necessary consequence, -hurtful instead of curative. - -“There may be other forms of quackery also under which some valuable -knowledge may lie concealed; and no better service can be rendered to -the profession or the public than to bring quack knowledge to the light -of day, and to make it available for the general good.” - -The publication of Dr. Wharton Hood’s book had however a different -effect on the public mind than what was intended. There was previously -a sort of general belief that the doctors might be right in dubbing -Bone-setters “quacks” without much discrimination as to who the -bone-setter was. Some of the complaints which appeared in the _Lancet_ -prior to this, were like the petulant utterances of a child deprived -of its plaything, rather than the opinions of a scientific inquirer, -for it must have struck the thinking part of the faculty, as it -subsequently did Sir James Paget, and gleamed on the writer in the -_Lancet_, that the fame of the many cures could not have been the -effect of chance, or the “luck” of ignorant charlatans. Mr. Archibald -Maclaren, who noticed Dr. Hood’s book in _Nature_, seems to have -been aware of this. He pertinently says with reference to his work -_On Bone-setting_, “It will be asked, What is Bone-setting, who are -the Bone-setters, and who are their patients? And it will be readily -answered Why, of course, Bone-setting is the art of setting bones that -have been broken, or joints that have been dislocated, and this is -done doubtless by surgeons; and equally doubtless, and of course their -patients are persons whose bones are fractured, or whose joints are -dislocated— - - “There needs no ghost come from - The grave to tell us that.” - -Perhaps not, but the answer is quite wrong for all that; quite the -reverse, indeed, of what is actually the case, for _Bone-setting -is_ NOT _the art of re-setting broken bones or dislocated joints; -Bone-setters are_ NOT _surgeons_, or regular practitioners in any sense -of the title; and then patients, even when they have suffered injury to -joint or bone, have been pronounced by the regular practitioner _cured_ -before seeking the help of the Bone-setter.” - -The writer very properly calls this “a triple paradox,” and quotes what -Dr. Hood has to say in explanation:— - - “A healthy man sustains a fracture of one or both bones of the - forearm, and applies at a hospital, where splints are adapted - in the usual way. He is made an out-patient, and the splints - are occasionally taken off and replaced. - - “After the lapse of a certain number of weeks the fracture - becomes firmly united, the splints are laid aside, and the - man is discharged cured. He is still unable to use either his - hand or his forearm, but is assured that his difficulty arises - only from the stiffness incidental to long rest of them, and - that it will soon disappear. Instead of disappearing, it - rather increases, and in due time he seeks the aid of the - Bone-setter. The arm and forearm are then bent nearly at a - right angle to each other; the forearm is intermediate between - pronation and supenation; the hand in a line with it; and - the fingers straight and rigid, the patient being unable to - move them, and also unable to move either the wrist or elbow. - Passive motion can be accomplished within narrow limits, thus - produces sharp pain, distinctly localised in some single spot - about each joint, in which spot there will be also tenderness - in pressure. - - “The Bone-setter will tell the man that his wrist and his - elbow are “out.” The man may object that the injury has been - in the middle of the forearm, perhaps from a blow or other - direct violence. The reply be then; perhaps the arm had indeed - been broken as alleged, but that the wrist and the elbow had - been put out at the same time, and that these injuries had - been overlooked by the doctors. The Bone-setters would then, - by a rapid manipulation hereafter to be described, at once - overcome the stiffness of the fingers, and enabled the patient - to move them to and fro. The instant benefit received would - dispel all scruples about submitting the wrist and elbow - to manipulation, and these also would be set free in their - turn. The man would go away easily flexing and extending his - lately rigid joints, and fully convinced that he had sustained - grievous harm at the hands of his legitimate doctors.” - -“The art of Bone-setting, then, is the art of overcoming these -impediments in joints, these conditions or impaired freedom which not -unfrequently supervene on the curative processes of treatment in use by -surgeons in case of fracture or dislocation, or which may arise from -and be observed only after the subsidence of active rheumatism, gout, -gangrene swellings, or other local affections; and this brings us to -the question—How is it done? how are these stiffened joints set free? -how are these impediments to healthy action overcome? The answer of the -regular practitioner is that which has been already quoted, namely—‘to -rest it’—advice which usually entails a distressing failure; the -answer of the irregular practitioner, _i.e._, the Bone-setter, is -precisely the opposite, namely—that freedom can only be restored to -the stiffened joint by movement, by manipulation, and manipulation, -too, of the most formidable kind, nothing less than suddenly and -forcibly rupturing, tearing asunder the adhesions formed between the -articulating surfaces of the affected joint, an operation which is so -frequently successful that it forms the very basis of the Bone-setter’s -craft.” - -This is very forcibly and clearly expressed, but its verbiage tends -somewhat to place the Bone-setter in a formidable and forbidding light, -as opposed to the regular practitioner, but as a matter of every-day -experience such is not the case. It is true, that the injury of years -cannot be removed in a twinkle of an eye, without the patient suffering -any pain or inconvenience. No bone-setter pretends to do that, but his -mode of procedure is not of that violent and repellant character which -Mr. Maclaren’s words would seem to imply:— - -“It is here,” continues Mr. Maclaren, “that the Bone-setter steps in -front of the scientific surgeon, _and we must confess to a feeling -of disappointment that their relative positions are not reversed_, -that the surgeon is not called in to rectify the malpractices of -the quack, instead of the latter being sought out to complete the -shortcomings of the former.” These are not our words, but the words -of an independent reviewer in a scientific periodical. He tells his -readers that the Bone-setter is not a man with only one remedy and one -resource, but that “he has a clearly defined system of treatment for -each separate joint, if not for each specific affection to which each -joint is subject.” What qualified surgeon, what regular practitioner -has more than that? He follows the dogma and doctrine of the schools. -The Bone-setter that of experience, practice and the traditions of -generations of practitioners. The one is recognised by law, and the -other is not. - -Mr. Maclaren seems to have seen that there was something which required -explanation in all this. With the facts in Dr. Hood’s book before him, -he says “Bone-setters, we are told, are for the most part uneducated -men, wholely ignorant of anatomy and pathology.” In the anecdotes of -Mr. Hutton, this is always accentuated in the professional accounts of -his proceedings, for he made a little boast of his ignorance, but the -writer continues, “we are not told what we greatly wish to know, and -that is, the manner and method in which the secrets, the mysteries, and -the other traditions of the craft, are communicated to each other.[6] -No doubt there exists a freemasonry in the craft, so that when -individual members meet, revelations are made and notes compared, but -we are not informed of any regular or organised system of instruction, -either for the maintenance and extension of the craft, as a craft, -or for the enlightenment of the separate and detached members of the -fraternity. The most celebrated, we may even say distinguished,[7] -Bone-setter of our day, was the late Mr. Hutton, whose successful -treatment of cases which had baffled the skill of the foremost surgeons -now living, as related in detail by Dr. Hood, and about the accuracy of -which there can be no question or doubt, is little short of marvellous; -and the question is ever recurrent, while we read ‘How and where was -this skill acquired?’ for a Bone-setter of Mr. Hutton’s calibre could -put his finger on the spot, where lurked the seat of an affection that -had crippled a patient for half a dozen years, and had defied the -scientific treatment of the ablest surgeons of our time; nay, he could -point to this spot without ever seeing the limb affected, guided merely -by observing the attitude, gait, or action of the patient. Now whence -comes this skill of these illiterate men? It appears to have been -gained solely by observation of symptoms and results of treatment, the -accumulated knowledge of from day-to-day experience; and, as we often -see that one sense is quickened and functional power increased by the -loss or impairment of some other sense; so, perhaps, the narrowing of -the field of instruction and counting of the sources of information, -may have intensified the powers of observation of the Bone-setters, -allowing in a measure for the absence of the revelations of science.” - -Is not this equally applicable to the oculist, the aurist, the dentist, -and to the “specialist” of every description. The Bone-setter keeps -within his special knowledge, and though he may be called “a quack,” he -can point to the results of his skill and experience, and ask if these -are quackery? The patients, whose sufferings have been alleviated, -_must_ answer, “If this is quackery, we wish there was more of it in -the world.” - - - - -CHAPTER V. - -_THE FACULTY IN DOUBT._ - - - “Why, what have you observed, sir, seems so impossible.”—_Ben - Jonson._ - -Like the Royal Society, when Charles II. asked that learned body the -answer to certain propositions, the medical profession continued for -years to “hum and haw” over the self-evident fact that Bone-setting -was not only an institution, but a successful profession. I have taken -somewhat at random from my voluminous collection of notes on the -subject, a few of the printed opinions of those “who were convinced -against their will,” but could _not_ “be of the same opinion still,” -but wished to modify the self-evident facts or gloss them over to -harmonise with previously expressed declarations. - -[Illustration: PLATE V.—FRACTURES. - -19. Disunited fracture. 20. Fracture of pelvis. 21. Extra capsular -fracture of humerus. 22. Fracture of scapula. 23. Fracture of jaw. 24. -Fracture of femur.] - -In 1880, the Clinical Society, at their meeting, held on April 9, had -the subject of “Bone-setting” under discussion. Mr. Howard Marsh, whose -experience is elsewhere given (page 95) gave instances of a number of -cases he had treated after the Bone-setter’s manner, and which had -been quite successful. He gave his testimony to the great service Sir -James Paget had rendered to the profession by drawing attention to -the subject in his clinical lectures which had since been republished -with others (see pp. 69-74). He further said that _displacements of -cartilages, and slipped tendons might be, and doubtless sometimes -were, put right by Bone-setters; but he believed the cases of -adhesions—especially such as occurred after an injury outside a -joint_, which itself was healthy, afforded by far the most numerous -instances of improvement after forcible movement, and he expressed -his conviction that they were much more frequent in practice than -was generally supposed. He gave other several instances where he had -followed the Bone-setter’s treatment as given by Dr. Wharton Hood. -He, of course, was silent as to the practice of the Bone-setters in -reducing fractures, and their treatment of cases which never came under -the care of the faculty at all, and which were satisfactory to the -patients. - -Mr. Hulke thought it was an approbrium to surgery that so many -persons sought advice from Bone-setters, and he mentioned that “even -intelligent people are blinded by these men!” Many alleged instances -of injury following the treatment of the Bone-setter, but there was a -little contemptuous tone with respect to country surgeons, which ere -long evoked a reply. - -In the next number of the _Lancet_, there appeared a letter from Dr. -D. H. Monckton, of Rugeley, pointing out that it would seem “that the -chief object sought in the debate was to prove to country surgeons that -their metropolitan brethren understand, and can cure such conditions -of the joints if only they are sent up to them.” In other words, -they want to occupy the place and receive the fees of the ousted -Bone-setters, whose secrets they had appropriated, after covering them -with approbrium as quacks and empirics. - -At another meeting of the profession there was the same _pro_ and _con_ -argumentation. The obvious “willingness to wound,” but yet “afraid to -strike” in the face of the overwhelming testimony in favour of the -_bete noir_ of the profession:—the healer outside the fold “who in the -wilderness doth stray.” At this meeting Dr. Bruce Clarke read a paper -on the practice of the Bone-setter, in which after briefly alluding -to the variety of cases that found their way to the Bone-setter, and -derived benefits from his treatment, he adverted to the pathology of -stiff joints, and showed from observations of several cases which he -had been able to examine after removal of the limb, that adhesions -were usually found outside joints and tendon sheaths, and were due -to contractions of the connective tissue of the limb. Adhesions were -rarely formed inside the tendon sheaths or joints, and when they were, -the disease was far more serious and rarely yielded to treatment. In -cases of old stiff joints, the skin, and probably the subcutaneous -tissues, became weakened and atrophied by disease, and were so rendered -more liable to injury—in proof of which he cited several examples of -tearing and lacerating the skin without the employment of due violence. -The usual history, he tells us, of the class of cases that came under -the hands of the Bone-setter was this:— - -The patient met with an injury resulting in a dislocation, or fracture, -or perhaps, only a severe bruise, or a sprain. He readily recovered -up to a certain point; but when all inflammation had subsided, there -remained a stiffness accompanied by pain on movement. In other cases -there were periodical attacks of synotictus. The treatment in all -such cases was active movement, with or without chloroform, which was -usually accompanied by a click or crack, ascribed by the Bone-setter -to the replacement of a bone, but which was due to the freeing of the -connective tissue bands. In slight cases, one violent flexion might -cure the trouble of months: in severe cases, the treatment might be -measured by months rather than minutes. The pathology of such cases -was as well marked as that of iritis, where there was the advantage -of seeing the adhesions not only form but rupture and disappear. He -expressed his obligation to Mr. Wharton Hood’s lecture which had -induced him to study the subject. The difficulty of these cases was -the selection of time for rupture, and for rest. Signs of inflammation -were their guides in that matter. Rest should be regulated to its -proper position in surgery, and should not be kept up when it increased -instead of abating the patients’ troubles. - -Dr. Keetley thought Dr. Clarke could hardly have chosen a more -interesting subject, undoubtedly, the Bone-setter frequently earned -great credit by the manipulations which broke down adhesions outside -a joint, and at the same time, removed the cause of inflammation, for -in these cases there was no contraction of membrane. When there was an -osseous fibrous hand the case was of a strumous origin, it was due to -the presence of organisms. In such cases the joints became altered, -and there was great danger from the rough usage of the Bone-setter. -In the treatment of such joints he had put on ice for several days -with great advantage, and had repeatedly put them straight. When -once convalescent, a joint very rarely became strumous. There was -much bewilderment with regard to the value of rest, which was only a -negative factor. It was the natural tendency of a column of germs to -die as the joint became healthy. - -Dr. Alderson related the case of a knee which became enlarged fourteen -days after confinement, but without pain. He called in Dr. Hewitt who -ordered rest, and the knee to be rubbed with salad oil. He also used -Scott’s dressing. Subsequently, at Brighton, a sea-weed poultice was -used. The treatment was successful. - -Dr. Alden Owles had seen several cases confirmatory of the opinions -advanced in the paper. Once was a shoulder, the manipulation of which -caused agony to the patient, but in which motion was regained. Another -regarded at first as a strumous joint was eventually cured by somewhat -violent manipulation. - -Dr. Vinen referred to the case of an officer of the 60th Regiment, who -sustained a compound fracture below the knee whilst playing at football -in India. The bones were set by some naval surgeons who were watching -the game; but in consequence of the leg being deformed, the adhesions -were broken and the limb reset. The ankle then remained fixed, and the -patient’s health suffered. However, Mr. Erichsen was called in, broke -the adhesion, and the patient recovered so thoroughly, that he was -enabled to rejoin his battalion in the Transvaal. Dr. Bruce Clarke in -reply, pointed out the necessity of distinguishing chronic cases, as -such were usually made worse by movement. - -In the course of this discussion only one point of the Bone-setter’s -practice was alluded to—that of rigid or strumous joints, as if the -renown of the Bone-setters art rested on these alone. “There are none -so blind as those who will not see.” - -[Illustration: PLATE VI.—FRACTURES. - -25. Fracture of humerus. 26. Fracture of ulna. 27. Colles’ fracture. -28. Compound fracture of leg (tibia and fibula).] - - - - -CHAPTER VI. - -_DISPARAGEMENT AND VINDICATION._ - - - “Who shall decide when doctors disagree?” - -Dr. Howard Marsh, the learned Editor of Sir James Paget’s Lectures, -who had previously been subjected to the criticism of country -practitioners for his somewhat supercilious allusion to their failure -to adopt the processes of the Bone-setter, thought it becoming at -the jubilee meeting of the British Medical Association at Worcester -in 1882, to resume the worn-out sneer at the Bone-setter’s ignorance -and superstition. He seems, indeed, to have drawn on his imagination -for his facts, or to have resuscitated the history of his own -profession for that of the modern Bone-setter. From his high and -mighty stand-point he told the assembled medical practitioners in the -“faithful city” this faithless story:— - -“Bone-setters are a very miscellaneous group, who resemble each -other mainly in the negative point, that they have never studied -either anatomy, pathology, or surgery. Some are blacksmiths on the -Cumberland hills, or shepherds in the sequestered valleys of Wales. -Practitioners of this kind, standing in the same relation to surgery -that herbalists bear to medicine, have existed in these remote -districts from immemorial times. They belong to the same order which -in bye-gone times included fortune-tellers, ring-charmers, and the -workers of all kind of village miracles. At the other end of the scale -are practitioners of a less unsophisticated stamp. Residing in large -towns they equip themselves with the names of the principal bones and -muscles, and with a few stock medical phrases they procure a skeleton -on which they undertake to show patients the precise nature of their -complaints; they employ anæsthetics freely, and make full use of daily -passive movements, rubbing and shampooing; while in spinal cases they -often put on Sayre’s plaster jacket. These individuals however, are in -the same position as the most homely of their order in this important -particular—that diagnosis, properly so called, forms no part of their -system. Indeed, diagnosis and their method are two things incompatible. -At present, the Bone-setter’s programme is both concise and logical. -In every case alike he asserts that “a bone is out,” and that he can -put it in. Now, the second clause of this formula postulates the first. -But let him once enter upon diagnosis—let him once find, not that a -bone is out, but that the case is one of tumour, or paralysis, and he -has cut the ground from under his own feet. No. Beyond the assertion -that “a bone is out” or similar phrase, he never goes. If pressed for -particulars, he cuts the knot by saying, “I can cure you—what more -do you want?” Old Mr. Hutton, of Watford, used to say, “Don’t bother -me with anatomy—I know nothing about it.” A patient, therefore, who -consults a Bone-setter, is simply playing a game of hazard. His fate -depends on what is the matter with him. If he has a stiff ankle after a -sprain he will very likely be cured. If he has a strumous joint he will -be more or less injured, while if he has a bunion, or a node on his -tibia, he will find himself neither better nor worse for his venture.” - - * * * * * - -I have quoted Mr. Howard Marsh thus far without comment in order to -show that he is something like the Old Bailey advocate, who thinks -to serve his clients best by abusing the attorney on the opposite -side. He seems neither to have learned Sir James Paget’s admissions, -or was anxious to pose as a dogmatic teacher at the expense alike of -truth and experience. His whole knowledge and deductions are made from -the two or three cases related by Dr. Wharton Hood, for so learned -a doctor was not likely to look for facts in the domain of general -literature outside the schools. He then proceeded to say—“But how is -it that Bone-setters sometimes succeed where surgeons have failed? My -answer is the following:—There are a considerable number of minor -ailments of and around the joints that interfere with free movement, -or produce pain, such as adhesions, slipped tendons, hysterical -affections, rigidity of the muscles, &c. These conditions, though they -differ widely from each other, and are met with under a great variety -of circumstances, have yet this one point in common, that they may be -cured by free movement. - -“Now, how have Bone-setting and surgery respectively dealt with these -cases? What is Bone-setting? Bone-setting is a system embodied in a -single clause. Ignoring alike anatomy, pathology, and diagnosis, it -begins and ends in a summary act of treatment. It consists in the -process of carrying the affected joint through its full natural range -of movement in all directions, especially in the direction in which -there is the greatest resistance. Thus, a Bone-setter, who says, in -every case alike that a bone is out, and that he can put it in, is -like a practitioner who should tell all his patients alike that their -complaint was constipation, and should promise to cure them all with -sulphate of magnesia. Now, although sulphate of magnesia given for -strangulated hernia or typhoid, or Bone-setting employed for sarcoma -or a scrofulous joint, can do nothing but harm, there are many cases -in which both these agents do real good; and these genuine successes, -like the fragment of truth that lies at the bottom of every method -which shows any sustained vitality, are enough, when they are seen -through the glamour that surrounds this system to outweigh in the eyes -of the public the failures that stand on the other side of the account. -How has it been with surgery? Surgery is no stranger to the use of -manipulation. The method has frequently been employed, and is fully -discussed in the writings of many surgical authorities; but it has -always been unpopular; and for this reason. - -It has been used mainly in cases in which limbs have been left stiff -or distorted after the subsidence of serious disease of the joints -themselves, and the result has been disappointing. The joint though -yielding freely under manipulation, has usually grown stiff again; and -not rarely there has been a fresh outbreak of the original disease. -These, however, are not the cases which are suitable for this method. -If the secreting structure of the synovial membrane has once been -destroyed, or if the cartilage has been removed and replaced by -adhesions, the joint is practically converted into a cicatrix, and -although that cicatrix may be completely torn across the functions -of the articulations cannot be restored. The effect of these cases -has been that, finding they have done no good, and sometimes even -harm, surgeons have too much discarded manipulative treatment, and -have too exclusively adopted the motto _non vi arte_. Thus it has -happened that Bone-setters, helped by their ignorance, have stumbled on -success, while surgeons, deterred by the unsatisfactory results, met -with in a particular group of cases, have refrained from manipulation -in instances in which it is the only treatment that is likely to be -efficient. - -I have said that a Bone-setter’s formula is, that a bone is out, and -that he can put it in. To do this he carries the limb through all its -natural range of movement, and he stops only when all resistance has -been overcome. Thus, if a knee is flexed, it has to go straight just -as a horse that jibs at a fence—if he happen to have a rough rider on -his back—has to go over it. In the majority of cases, however, the -force that is used in a majority of cases is absolutely slight; for, -in the first place, an anæsthetic is often given, so that the muscles -being relaxed, the effort used takes effect directly on the source of -abnormal resistance, whatever that may be. Secondly, Bone-setters -acquire by practice much facility in handling and moving the various -joints; they know how to seize the limb at a advantage, not only with -the force, but with the skill of a wrestler; and thirdly, in cases -in which an anæsthetic is not given, they take care to divert their -patients’ attention so that the muscles are off their guard. - -In the common run of cases in which Bone-setters succeed, very moderate -force is sufficient to break down all resistance that is encountered. -This latter is a very important point. The main objection entertained -by surgeons to manipulation is that it is a resort to violence; it is -_vi non arte_. This view, however, if founded mainly on the experience -of cases in which fibrous ankylosis of the larger joints has been -broken down. But these, I venture to repeat, are not the cases by -which to judge this method. I can recall but few cases in which free -motion has been restored to a joint that could be moved only by the -use of considerable force. The most striking successes are obtained in -instances in which some slight impediment to motion is easily overcome. -Indeed, it may be taken as an axiom—almost, perhaps, self evident, -that the less the force which is required to remove the impediment, the -more successful will be the result. Thus so far from the opinion being -a correct one, that manipulation is necessarily a resort to violence; -the truth is, that in appropriate cases, force which could inflict -injury on the natural structures is very seldom required. I think -when this fact is more clearly recognised, much of the distrust now -entertained respecting manipulative treatment will have been removed.” - -[Illustration: PLATE VII.—DISLOCATIONS AND RUPTURES. - -29. Dislocation of spine. 30. Appearance of bones in Pott’s fracture. -31. Appearance of foot in do. 33. Fracture of patella (separation of -fragments). 34. Signs of fracture of patella on knee-cap. 35. Rupture -of long tendon of biceps.] - -Thus Dr. Howard Marsh argues admittedly on the slightest and most -imperfect knowledge of the Bone-setter’s art and their method of -procedure. He is kind enough to admit that they sometimes reduce -recent dislocations, disperse a bursa, and succeed in nervous so-called -hysterical joints and spines. (See George Moore’s case, 29-32 _ante_.) -They sometimes, he admits, “replace a slipped tendon,” and operate -successfully in cases of internal derangement of the knee joint, and in -relieving joints which, though healthy, are stiffened and painful from -surrounding adhesions. He approves to some extent of manipulations, -and his whole paper is one of disparagement, or “damning with faint -praise.” - - - - -CHAPTER VII. - -_VINDICATION._ - - - “Is this then your wonder? - Nay, then, you shall understand more of my skill.”—_Ben Jonson._ - -Lest it should be thought that I have only my own authority for calling -in question Dr. Howard Marsh’s dogmatic assertions with respect to the -method of practice by modern Bone-setters I find at the same medical -jubilee, Mr. R. Dacre Fox, Fellow of the Royal College of Surgeons, -of Edinburgh, the surgeon to the Southern Hospital, Manchester; -surgeon to the Manchester police force, and whose other practice and -official appointments entitle his opinion to some weight, gave his -practical experience of the Bone-setter’s art, so entirely different -and so much nearer the truth, that I shall content myself with merely -quoting, whilst thanking him, for his remarks which appeared in the -_Lancet_, for 1882 (vol. ii. pp. 844.) Speaking from three years’ -experience with the late Mr. Taylor, a celebrated bone-setter at -Whitworth, Lancashire, whose family have been bone-setters for more -than two hundred years, he told the medical men in plain terms that, -“Much misconception exists as to the practice of Bone-setters; many -of the methods of treatment popularly attributed to them have no -other existence than in the imagination of ignorant patients, whose -stories we, as a profession, are perhaps rather too ready to believe. -It is certain that some families—notably the Taylors, Huttons, and -Masons—have by their manipulative and mechanical skill justly acquired -a great reputation. In what has their practice consisted? First, in -the treatment of fractures and correction of deformities. The general -impression in the profession appears to be that the Bone-setter’s art -consists of nothing more or less than the forcible “breaking up” of -stiff joints, so as to make the same man walk as if by a miracle. The -practice at Whitworth was a large one, furnishing constant employment -for at least two active men, and consisting chiefly of the cases I have -mentioned. Speaking from memory, I do not believe that fifty joints of -all sorts were “cracked up” during the time I was there; but it was -not an uncommon event to have to put up half a dozen fresh fractures -and twice as many recent sprains in a single morning. In the North -of England, the origin of nearly all the men who are fairly good at -Bone-setting can be traced to the Whitworth surgery, and while, so far -as I know, the Taylors, in their various settlements at Whitworth, -Todmorden, Stock-wood, and Oldfield-lane, were the only qualified -surgeons who practised Bone-setting; amongst the hills and dales of -Lancashire, Yorkshire, and the Lake district, there were many who did -so without being qualified, some of whom, I must in fairness say, put -up fractures uncommonly well. But apart from the legitimate credit they -have won by the skill displayed in their handicraft, they owe some of -their success to the carelessness or indifference of the general body -of practitioners, who are apt to overlook little injuries which often -become very painful and troublesome. It sometimes seems to me that -it is beneath the dignity of the ordinary practitioner to employ any -active treatment whatever for a sprain. It is hardly fair then to guage -the work of Bone-setters solely by their method of treating diseased -joints (probably the most unsatisfactory class of cases in the whole -realm of surgery), but we ought also to take into account the patience -and skill they display in the treatment of injuries for which they are -not unfrequently consulted by the patients of qualified practitioners. -I have no desire to hold a brief for every idle fellow who calls -himself a Bone-setter, but I am anxious to give credit where credit is -due, and to explain that the _art_ of Bone-setting is not what it is -often thought to be a mere mixture of charlantanism and good luck. - - * * * * * - -From my own experience, I should classify weak joints as follows:— - - 1.—Those that have become stiff from enforced rest. - - 2.—Those that have become stiff by chronic disease. - - 3.—Joints stiff from injury to the bones entering into their - formation. - - 4.—Joints stiff and weak from sprains, including displacement - of tendons and partial luxation. - -Apart from the previous history of the case, and the evident existence -of constitutional disease, there are some external appearances which -help to distinguish cases and to afford indications of treatment, -and of these the Bone-setters have learned by experience to avail -themselves. - -1.—In the first-class I have mentioned the stiffness of the structures -about the joint impeding its movement is the result of purely -mechanical causes, is in fact simply due to prolonged disuse. No cause -for functional activity exists, and consequently the elasticity, the -flexibility and power of adaptation to movement in the parts about the -joints not being required they become stiff and rigid. No degenerative -changes however taking place, and they are capable of being recalled -into activity unimpaired. In such a joint, the bony points, and the -outlines of the tendons and ligaments about it, seem unnaturally -prominent, probably from absorption of the adipose and connective -tissue; the rigid ligaments impart a sense of hardness, and if the limb -be flexed to its utmost, it shows considerable resilliency, such joints -may, I believe, be “cracked up” without fear of consequences, and -this constitutes one of the successful operations of Bone-setters. My -own recollection carries me back to some apparently almost miraculous -results. I am convinced _suddenness ought_ to be insisted on in doing -this; the advantage derived from it being, I believe, mainly due to the -fact, that it is less likely to set up any irritation in the joint than -the “dragging” of gradual extension. - -2.—In the next class of cases, in which stiffness is due to -degenerative changes, the external appearances are exactly reversed, -the outlines of the joint are more or less gone. In these cases, no -matter the character of the disease, manipulative interference is -positively vicious; and while it is in them that ignorant Bone-setters -do so much mischief, the better informed, by the use of splints and -well applied pressure, are highly successful in their treatment. I -am sorry to say many cases of this kind come to Bone-setters which -have not been properly treated before, owing to their not having been -recognised, especially hip-joint disease. - -3.—On the third-class of cases, in which a fracture has taken place -into the joint, causing stiffness, the condition is due to disturbed -relationship of the bones from faulty setting, and is recognised -by comparison with the bony landmarks of the sound limb. In these -cases forcible treatment does good; though, of course, the result is -in proportion to the amount of bone-displacement, but it should be -supplemented by passive movements for some time. In joints stiff after -diagonal fracture through the condyles of the humerus so common in -children, I have seen many most gratifying results; one in a boy about -twelve years old, whose elbow had been stiff three years is especially -impressed on my mind. - -4.—In the fourth-class of cases, and those to which I would draw -particular attention, I include lameness, and weakness, the result of -the various forms of injury, which we group together under the general -term a “sprain.” I affirm most unhesitatingly, from an experience -of some hundreds of cases, that nothing has done more to lower the -prestige of regular practitioners, and to play into the hands of -unqualified Bone-setters, than the way in which so many practitioners -tamper with a sprained joint. Sprains, of course, vary greatly in -severity; they may be broadly divided into two kinds, of which one -consists merely of a temporary over distention of the parts round a -joint which rest, and anodyne applications soon cure, while the other -involves pathological results a much more serious nature. A _severe_ -sprain is the sum of the injuries that the parts in and about a -joint sustain, when, by their passive efforts, they exercise their -maximum power of restraint to prevent luxation. Under such conditions -I conceive the following changes to take place in the integrity of -a joint. In the case of the synovial membrane, temporary hyperæmia -accompanied by pain, and some slight effusion into the cavity of the -joint. - -In the case of the tendons, over-stretching and loosening of the -lining membrane of their sheaths, more or less disturbance to the -adjacent cellular tissue forming the bed of the tendon groove, -and hyperæmia with exudation of plastic fluid, subsequently -forming adventitious products. In the case of the non-elastic -fibrous ligaments—firmly attached at either end to the adjacent -periosteum—over-stretching, mostly involving partial rupture, with -swelling, softening, and disintegration of their structure. It is -beyond the purpose of this communication to draw attention to the -plan of treatment adopted by Bone-setters under these circumstances; -it is, however, described in a paper of mine, of which an abstract is -given in the _British Medical Journal_, of September 25th, 1880. The -stiffness of a sprained joint is partial. The surface is generally -cold, or more or less œmatous, and each joint has one particular -spot in which pressure causes acute pain; the Bone-setters have learned -by experience the situation of these spots, and this fact has done more -than anything to strengthen the popular faith in their intuitive skill; -they certainly form an important guide to treatment since they indicate -the seat of greatest injury to the ligaments, and point out where their -power of passive resistance has been most severely tested, and where -adhesions are most likely to have formed, Dr. Hood, in his record of -Mr. Hutton’s practice, has enumerated some of these painful spots, the -chief of them are as follows:— - -1.—Over the head of the femur in the centre of the groin, -corresponding to the ilio-femoral band of the capsular ligament (which -is most severely stretched when the thigh is over extended, as when the -trunk is flung violently backwards the commonest cause of a sprained -hip). - -2.—For the knee joint, at the back of the lower edge of the internal -condyle, in other words, at the posterior border of the internal -lateral ligament where it blends with Winslow’s ligament, and where the -senior membranosus tendon is in intimate relation with it. These parts -suffer most because as Mr. Morris says: ‘During extension they resist -rotation outwards of the tibia upon a vertical axis’ and a sprained -knee is almost always caused by a twist outwards of the foot. - -3.—For the shoulder at the point corresponding to the bicipital -groove, because in nine cases out of ten a man sprains his shoulder to -prevent himself from falling, his hand grasps the nearest support, the -body is violently abducted from the arm, the long head of the biceps -is called upon to exert its utmost restraining power, the bicipital -fascia is overstretched, and the tendon very often displaced. - -Again for the elbow the painful place is at the front of the tip of -the internal condyle; the fan-shaped internal lateral ligament has -its apex at that point, and it is most stretched in over-supination, -with extreme extension of the forearm. On the front of the external -malleolus, at the apex of the plantar arch, the tip of the fifth -metatarsal bone, the styloid process of the ulna, the inside of -the thumb, and the annular ligament in the front of the wrist, are -respectively the most painful spots when those joints are severally -sprained. - -The manipulative part of the treatment of joints stiff from being -sprained may be briefly said to consist in pressure over the part -most injured, and momentary extension of the limb, followed by -sudden forcible flexion. The method varies with each joint, and I -can with confidence refer you to Dr. Wharton Hood as being faithful -word-pictures, supplemented, too, by very accurate drawings. - -The following are some of the lesser injuries, the non-recognition of -which has frequently come under my notice at Whitworth. In the upper -limb: fracture of the tip of the acromion; practical luxation of the -acromio-clavicular and sterno-clavicular joints (often happening to men -who carry weights on their shoulders); partial dislocation of the long -head of the biceps, with over extension of the bicipital fascia (common -in men who throw weights or use a shovel as malsters or navvies). -Dislocation of the head of the radius forward on the condyle, which -is very common in children, and has a marked tendency to cause stiff -elbows; fracture of the tip of the internal condyle; overlooked Colles’ -fracture; partial luxation of the head of the ulna (impeding supination -of the hand, and having a tendency to gradually grow worse); severe -sprain at the carpo-metacarpal joint of the thumb (very common in stone -masons and caused by the ‘jar’ of heavy chisels). - -In the lower limb: Fracture of the fibula, just above the malleolus and -at its tip (these are fruitful sources of lameness, often overlooked, -and, if of old standing, very troublesome to treat); partial rupture -of the ligamentum patellæ at its insertion into the tubercle of the -tibia, which is much more common than is ordinarily supposed; neglected -over-stretching of the ligament of the plantar arch, and tearing of -the plantar ligament at its insertion into the os-calcis; rupture of -the penniform muscular attachments of the tendo Achillis and muscular -hernia in the calf. - -I trust I shall be forgiven if I have dwelt too much on the -_étourderie_ of some of us, but I am sure so-called _trifling_ injuries -deserve more attention at our hands, since living at the high pressure -men do now-a-days, with every part of their bodies tested to its -utmost capacity, the slightest impairment of the mechanism of a limb -must be an incalculable source of personal annoyance, discomfort, or -disability. - -“When doctors disagree who shall decide?” The readers of this little -manual will probably say as they read Mr. Dacre Fox’s paper, that it is -alike a testimony and a vindication of the “Art of the Bone-setter.” - - - - -CHAPTER VIII. - -_WHAT BONE-SETTERS CURE._ - - - “Man’s life, Sir, being so short, and then the way that - leads unto the knowledge of ourselves, so long and tedious; - each minute should be precious.”—_Beaumont and Fletcher._ - -Throughout the many references to the Bone-setter and his art, which -I have quoted in the foregoing pages, the Bone-setter is constantly -misrepresented. He is described as a man of one idea, one formula, and -one mode of operation. His ruling idea is said to be that a “bone is -out” in all cases submitted to him. His formula to wrench the joint -so as to break adhesions, and to replace the bones in their normal -conditions. His mode of operation is said to be brute-force suddenly -applied. Nothing can be further from the truth. It is an offhand -generalization from a few cases out of thousands, and therefore -misleading. If these statements were true there would be but few who -would trust themselves and their painful limbs to the Bone-setter’s -care lest his force should be applied in the wrong direction. A -brother Bone-setter (Mr. J. M. Jackson, of Boston), has pointed out -how irrational and absurd Mr. Hood’s statements on the one hand and -admissions on the other necessarily are. Bonesetters, as a rule, are -as regular and legitimate in their practice as any medical man can be, -though they are not recognised by law. As Mr. Jackson truly says: “All -kinds of fractures and dislocations, and other injuries are constantly -being placed under their care and treatment, with the utmost confidence -on the part of the patients and their friends; a confidence inspired by -indisputable success on the part of a practitioner in a given locality -and district, for a series of years—it may be for a lifetime.” Mr. -Jackson, in his timely little pamphlet, very truly points out that -“living reasons” for this confidence can be found in town and country -where the practice has been carried on, or who have experienced the -greatest benefits under the skilful treatment of the Bone-setter, even -after the wisdom of the faculty had declared there was nothing wrong. -That such men are ignorant of anatomy, and but seldom have dislocations -under their care, and, that when they have, and succeed in replacing -the joint, that it is done unconsciously, and what they do is the -result of blind chance and ‘sudden movement’ without any knowledge of -how, or why such results are brought about; the idea is ridiculous -in the extreme; upon this hypothesis the practitioner would nearly -approach the “supernatural!” I am glad to record this opinion, because -it not only reflects the opinion of the public, but shows that the -faculty have tried to prove too much. The position of the Bone-setter -may be clearly defined, thus:—“_We lay no claim to skill beyond what -is the result of sound original teaching, thoughtful consideration, and -common sense_,” and we possess well-earned reputations won in proof -that we have succeeded in our special practice. - -[Illustration: PLATE VIII.—FRACTURES, ETC. - -36. Displacement of bones of foot in Pott’s fracture. 37. Badly -set Pott’s fracture (curable). 38. Rupture of rectus femoris. 39. -Dislocation of metatarsus. 40. Dislocation of metatarsal bones.] - -Even at the risk of being classed by the present, or some future Dr. -Howard Marsh, as being amongst those sophisticated Bone-setters, -“who keep a skeleton in the cupboard,” or a few bones to amuse the -credulous, I cannot close this little manual without saying something -about the bones of the human skeleton. Throughout the extracts I have -quoted from surgical and other writers, reference is made to the -various parts of the body, where bones are fractured, or “put out.” -These bones are mentioned by their scientific names, and may be as -_caviare to the million_. I have therefore inserted a rough engraving -of a skeleton, plate I., pp. 1 which cannot offend the susceptibilities -of surgeons, for it is one which is placed in the hands of the students -of the ambulance classes of the Order of St. John of Jerusalem, in -England. It will be observed that the skeleton is divided into three -parts. 1. The Head; 2. The Trunk; and 3. The Limbs, i.—The _Head_ has -the skull-cap and face. ii.—The _Trunk_, the back-bone, breast-bone, -with the ribs. iii.—The Limbs; the shoulders and arms; the haunches -and legs. The shoulders and arms are the origin of prehension, whilst -the haunches and legs form the origin of support and progression. The -skull is composed of eight and the face of fourteen bones. The facial -bones, except the lower jaw, are firmly pressed together. The latter is -the one subject to dislocation. - -The Trunk is divided into 1.—The thorax, or chest. 2.—The abdomen, or -belly. 3.—The pelvis. - -The bones of the Thorax, are i.—The spine (behind). ii.—The sternum, -or breast-bone (in front); and iii.—The ribs and the cartilages (at -sides). The _Spine_ is divided into five parts. There are seven bones -in the _Cervical_ or neck portion. Twelve bones in the _Dorsal_ or back -portion. Five bones in the _Lumbar_ or lower portion. There are five -bones fixed into one in the _Sacrum_ or rump bone. The incipient tail, -this _Os Coccyx_ terminates the column. - -The STERNUM, or breast-bone, forms the front of the chest; it has -attached to either side a collar-bone and the cartilages of seven upper -ribs. - -The RIBS are twelve pairs of bony arches forming the walls of the -chest. They are all attached behind to the spine. The upper seven are -termed _true_ ribs, being fixed to the breast-bone by their cartilages: -the lower five are termed _floating_ or _false_ ribs, having no -attachment in front. - -The ABDOMEN is supported behind by the lumbar spine, and below by the -bones of the pelvis. - -The PELVIS is the basin-shaped cavity which forms the lowest portion of -the trunk; and contains the bladder, the internal organs of generation, -part of the intestines, and several great blood-vessels and nerves. The -pelvis is composed of four bones—_2 Innominate or haunch-bones._ _1 -Sacrum or rump-bone._ _1 Coccyx._ - -The INNOMINATE or haunch-bones, with the lower portion of spine (sacrum -and coccyx), form the lowest portion of the trunk. The innominate bones -on their outer surfaces have cup-like depressions for the reception of -the heads of the thigh-bones. - -The SHOULDER is formed by the _clavicle_ or _collar-bone_ and _scapula_ -or _blade-bone_. - -The CLAVICLE, or collar-bone, has a double curve; it marks the line -dividing the neck and chest. - -The SCAPULA, or blade-bone, lies on the back of the chest, is of a -triangular shape, and forms the socket for the humerus or arm-bone. - -The UPPER LIMB comprises—1 _Humerus_, arm-bone. 2 _Radius and -Ulna_, fore-arm. 8 _Carpus_, wrist. _Metacarpus_, palm. _Phalanges_, -finger-bones. - -The HUMERUS, or bone of upper arm, extends from the shoulder to the -elbow; above, it is joined to the scapula, and below to the bones of -fore-arm. - -The ULNA is the larger bone of the fore-arm, lies on the inside, and -extends from elbow to wrist. - -The RADIUS lies on the outside of the fore-arm. - -The CARPUS is a double row of small bones which help to form the -wrist-joint. - -The METACARPUS consists of five bones, and forms the body of the hand. - -The PHALANGES are the fourteen finger-bones. - -The LOWER LIMB is composed as follows:—1 _Femur_, thigh-bone. 1 -_Patella_, knee-cap. 2 _Tibia and Fibula_, leg-bones. 7 _Tarsus_, -ankle-bones. 5 _Metatarsus_, instep-bones. 14 _Phalanges_, toe-bones. - -The HIP joint is a ball-socket joint, and is somewhat similar to the -joint at the shoulder. - -The FEMUR, or thigh-bone, extends from hip to knee joint, both of which -joins it helps to form. - -The PATELLA (_knee-cap_) is the small oval bone which forms the -prominent point of knee. - -The KNEE JOINT is formed by the lower end of femur, the patella, and -the upper end of the tibia. - -The TIBIA is the main bone of the leg, and extends from knee to ankle, -on the inside of the limb. - -The FIBULA is the small bone on the outside of the limb: the lower ends -of the tibia and fibula form prominent projections at the sides of -the ankle. - -The TARSUS, ankle-bones, are seven irregular shaped bones, firmly -united together; above they are attached to the tibia and fibula, and -in front to the metatarsus. - -The METATARSUS forms the instep, and together with the tarsus the arch -of the foot. - -The PHALANGES, bones of the toes, are fourteen in number, two for the -great toe, and three for each of the others. - -These bones are liable to be broken, dislocated, or fractured by -violence. Fractures or broken bones, they are usually divided into four -classes, which are termed— - - 1.—Simple fracture, a simple break. - - 2.—Compound fracture, a flesh wound commencing with the - broken ends of the bone. - - 3.—Complicated fracture, injuries to soft parts, blood - vessels, nerves, or internal organs. - - 4.—Comminuted fracture, smashing of bones into pieces. - -They vary very much in extent and form. Some are very simple indeed, -and there is but little perceptible looseness of the ends of the -fractured part or sign of fracture. A case of this kind might easily -be mistaken for a mere contusion, which has often been done. Bones are -often broken obliquely, and with sharp points, and require skilful -treatment both in reduction and the application of splints. Compound -fractures, of course, require care and skill, but many fractures are -so easy to understand and rectify, that all is required is a little -common sense treatment. - -The SYMPTOMS of fracture are:—1. Alterations in shape and general -appearance (plate V., fig. 88., pp. xix).—2. Unusual mobility at seat -of fracture.—3. Crepitus or crackling in placing hand over the broken -part and creating motion with the other.—4. Shortening of limb.—5. -Some inequality felt on moving the fingers along the surface of the -injured bone. - -These have to be distinguished from dislocations, and in doing so, the -following facts must be remembered:— - - _Fractures._ _Dislocations._ - - Crepitus. No crepitus. - Unnaturally movable. More or less fixed. - Easily replaced. Replaced with difficulty. - Limb often shortened. Limb may be shortened - Seat of injury in the shaft or lengthened. - or body of the bone. Seat of injury at a joint. - -DISLOCATIONS are partial or complete. Partial dislocations are most -common and most difficult to understand, as the ordinary signs are -not so clear as in complete dislocations, and may be overlooked or -misunderstood, but as Mr. Jackson has before pointed out to the -experienced Bone-setter, symptoms, which cannot be described appear; -and motions, or want of motions equally unexplainable, are felt, so -that he has very little difficulty in determining the nature of the -injury. - -Partial dislocations, displacements of tendons, and other injuries of a -similar character, may sometimes be rectified a considerable time after -the injury has been sustained, but should be attended to within a short -time after the accident—at least, within a few days. Much, however, -depends upon the nature of the injury, that no definite time can be -given which the patient may take before seeking proper advice. - -Many of the cases so graphically described in “Chambers’ Journal” and -Dr. Hood’s book were evidently not complete dislocations, but partial -dislocations of joints or displaced ligaments, etc., which admitted of -being rectified by dexterous manipulation. - -In plate II., figs. 1 and 2, I have given the appearances of a -dislocated thumb and a dislocated finger (2) a very common form of -accident; fig. 3 shows the radius of the arm fixed forward; fig. 4 -shows the dislocation of the radius at the elbow-joint; and fig. 5 the -dislocation of the humerus or upper arm-bone at the shoulder joint; -figs. 6 and 7 the appearances of a dislocated shoulder-joint; fig. 8 -shows the radius dislocated forward a dislocated elbow; fig. 9 is a -painful and yet not uncommon accident, and one that frequently comes -under the Bone-setter’s care, whilst fig. 8 shows the dislocation of -the radius forward; fig. 10, plate III, page 35, shows its appearance -backward. - -The dislocation of the jaw is a laughable accident to all but the -sufferer (fig. 11), unfortunately it is liable to recur at any time -when the patient is laughing or gaping. - -The hip is likely to be dislocated by the jerking of the body. Figs. -12 and 13 show two modes in which this accident may present itself -when the “hip is out.” It is as well to lay the patient on the bed and -pack the knee with cushions or pillows so as to relieve the pain. The -manner of packing will depend upon the form of dislocation or injury, -but the position in which the patient lies the easiest is best, and in -that position it should be supported. Bran poultices should be applied; -scald the bran in hot water, or steam it, then put it into a bag and -lay it upon the hip as warm as it can be borne, and repeat it until -advice can be procured. - -Plate IV, page 68, gives representations of five varieties of -dislocation. The dislocated shoulder joint is shown at fig. 14. If -the elbow hangs off from the side, which will be the case if the -dislocation is downwards, it is well to place a small cushion between -the elbows and the sides and place the arm in a sling. The dislocations -of the first, inwards or outwards (figures 15 and 16), are very painful -and are frequently accompanied with sprains. Figs. 17 and 18 show -the dislocation of the knee and elbow joint and fig. 29, a curious -dislocation of the vertebræ of the neck and arm. - -In treating of fractures, two points have to be considered; 1.—To -reduce the fractured ends or portions to their natural positions; -secondly, to retain them there immovable till nature has effected -a permanent cure, or otherwise the result will be similar to fig. -19, plate V. It should be borne in mind that there is no urgency in -treating a broken limb, provided no attempt is made to remove the -person, but if the patient must be moved in the absence of a skilled -“Bone-setter,” it is an absolute necessity to secure the limb by -putting it in splints, which can be easily extemporised in the manner -taught in the ambulance classes of the Order of St. John of Jerusalem. - -A stretcher is the only safe means of conveyance for cases of fracture. -Unskilful handling may cause either serious mischief or even loss -of life; the dangers are pressing the sharp ends through the flesh, -blood-vessels, nerves, or into some internal organ, such as the lungs. - - -SPECIAL FRACTURES. - -FRACTURE OF THE SKULL is caused by blows or falls. The external signs -are not always present. In fracture of the base there may be hæmorrhage -from ear, mouth, or nose; red patches of blood under conjuctivæ of -eyes; and oozing of watery fluid from the ears. Accompanying these -there may be symptoms of concussion, or symptoms of compression. - -_Treatment._ Place the patient in a dark and quiet room on his back, -with head slightly raised. Apply cold to head as soon as reaction sets -in and patient gets hot and feverish, and send for a surgeon. - -FRACTURE OF LOWER JAW (Fig. 23, plate V.), is caused by direct blows; -falls on chin. The symptoms are irregularity in the line of the teeth -and the outline of the lower margin of bone; inability to move jaw. The -treatment is simple. First fix lower jaw to upper jaw by a bandage, -until the Bone-setter or surgeon connects the fractured parts. - -FRACTURE OF COLLAR-BONE is caused by blows on shoulder; falls on elbow -or hand. It is a frequent accident, and when it occurs the shoulder -sometimes drops; finger along the arm is helpless, and there is an -irregularity on drawing surface of bone; a pad should be placed in -arm-pit, bind the arm to side just above elbow, and sling forearm, as -when a “shoulder is out.” - -FRACTURES OF RIBS are variously caused by blows, falls, weight passing -over chest or back; there is pain and difficulty in breathing, and the -usual signs of fracture. All that can be done at first is to apply a -broad roller bandage firmly round chest, so as to prevent all movement; -or strap the injured side with adhesive plaster. - -FRACTURE OF THE HUMERUS (Fig. 21). It is caused by direct falls on -elbow (fig. 26). The symptoms are mobility at seat of fracture, -crepitus, or crackling, shortening, usually present when fracture is -oblique, as in fig. 25. Apply first a roller bandage from hand to -elbow, abduct arm and apply three or four splints from shoulder to -elbow. Support arm in a sling. If there is looseness about the part -apply a splint; if the flesh is broken stop the bleeding as directed -elsewhere; if, however (as is often the case in a fracture of the -forearm), there is no particular looseness of the bones, the case may -be treated as dislocations and injuries to muscles, ligaments, &c. (see -page 36.) - -FRACTURE OF THE FOREARM is variously caused by direct violent blows, -falls, &c. The symptoms are crepitus, mobility, alteration in shape of -arm (fig. 27), and in treating it, semiflex forearm with thumb pointing -outwards. Apply two splints, one in front from bend of elbow to the -tips of the fingers, and one behind from elbow to knuckles. The splints -should be well padded. Place arm in sling. - -FRACTURES ABOUT WRIST AND HAND are caused by blows or other injuries. -There is pain, swelling, irregularity in the outline of the bones and -crepitus. The limb must be bandaged to a flat board or splint, and -supported by sling. - -FRACTURES OF FEMUR OR THIGH-BONE (fig. 24) are caused by blows or -falls, and pain and loss of power is instantly felt with crepitus, -shortening, or the broken ends may be felt and the foot turned out. - -FRACTURES (both of the leg or thigh).—First straighten the limb if -bent, then tie a handkerchief round the fractured part, after which -place a splint made of a broad lath, or something like it, from one -joint to the other—say from the knee to the hip, if it is a broken -thigh—and then tie handkerchiefs above and below the fracture, near -the ends of the splint, tie the limbs together at the ankles, knees, -and elsewhere, so that one supports the other. The object is to prevent -motion of the fracture while the injured person is being moved, either -to home or hospital. In doing this care should be taken to avoid -jolting or shaking, as far as possible. - -FRACTURE OF PATELLA OR KNEE-CAP (fig. 33) may be caused by blows, or -excessive muscular action, and the person is made to stand upon leg -first. Fragments can also be felt. Raise limb to a position at right -angles to body, and apply a figure-of-eight bandage around the knee, -including the fragments. - -FRACTURES OF BONES OF THE LEG (fig. 28), are frequent from blows, -falls, crushing weight, such as wheels passing over the limb. There is -pain and loss of power; alteration in shape; crepitus, and the broken -ends may be felt. Apply two splints, one inside and one outside the -limb, as directed above, and elevate limb. - -FRACTURES ABOUT FOOT AND ANKLE. These are various results of blows -or other injuries—(see figs. 30, 31, 36, and 37)—pain, swelling; -alteration in outline of bones; crepitus. _Treatment._—Elevate foot; -apply cold water. - -It must be remembered that the treatment for fractures here given is -only temporary, to enable the patient to be moved without further -injury, which might result in the loss of the limb or even life, till -advice can be had. - -When the fractured bone protrudes through the flesh, and there is much -bleeding, first straighten the limb and close the wound, and tie a -handkerchief tightly round over the wound, until a pad can be made, -then as quickly as possible make a pad by folding old rags or cloth, -or anything of the kind to be got closely together, of some thickness, -and broad enough to cover the wound well, then remove the handkerchief -already tied on, and place the pad over the wound and tie it lightly, -so that the pad presses hard upon the wound and stops the bleeding; the -bandage or handkerchief cannot well be too tight. Many a life might -be saved, which is now lost if this or a similar method were adopted -promptly. The materials are almost always at hand, and the application -of them easy and simple. Immediately after the bleeding is stopped -remove the sufferer, and call in professional advice without delay. - -The stoppage of bleeding from arteries is taught practically in the -ambulance classes, and though it forms no part of the Bone-setter’s -art, yet many a life may be, and has been saved by this little -knowledge, so I subjoin the directions given in the hand-book of the -order of St. John, by the lamented Surgeon-Major Sheppard, whose -humanity cost him his life after the battle of Isandula. - - “_The following situation of the main arteries in the - different regions of the body, and their treatment when - wounded._” - -IN THE REGION OF THE HEAD there is the _Temporal Artery_ in front of -ear, one _P. Auricular_ at the back of ear at the _Occipital_, back of -head. Compress over the wound, and bandage. - -IN THE NECK the _Carotid Arteries_ ascend in a line from inner ends of -collar-bones to angles of jaw. Digital compression in line of vessels -above and below the wound, or directly into wound on the mouths of the -bleeding vessels. - -IN THE ARMPIT, the _Auxiliary Artery_ lies across hollow space of -armpit. Compress subclavian artery behind middle of collar-bone, or -digital pressure into the wound. - -IN THE UPPER ARM, the _Brachial Artery_ lies on inner side of arm, in -a line with seam on coat sleeve—from inner fold of armpit to middle of -bend of elbow. Compress artery by a tourniquet above wound. - -IN THE FORE-ARM the _Radial and Ulnar Arteries_ begin below the -middle of bend of elbow, and descend one on each side of the front of -the arm to the wrist. Compress Brachial artery in the upper arm by -a tourniquet, _or_ place a pad in hollow of elbow and bend fore-arm -against arm. - -IN THE PALM OF THE HAND, the _Radial and Ulnar Arteries_ give a number -of branches, which spread out and supply the palm. Apply two small firm -pads to arteries at wrist, or forcibly close and fix hand over a piece -of stick or hard substance, and bandage. - -IN THE THIGH, the _Femoral Artery_, from middle of fold of groin runs -down the inside of thigh in its upper two-thirds. Pressure at middle of -fold of groin, with fingers or by tourniquet above wound. - -IN THE HAM, the _Popliteal Artery_ lies along the middle of ham. -Compress popliteal artery above wound, or compress femoral artery in -front of thigh by tourniquet. - -In the BACK OF THE LEG are the _Post_, _Tibial_ and _Peroneal -Arteries_ descend the back and outside of leg from below ham, passing -behind ankle-bones. Compress at ham or in front of thigh or double leg -on thigh with a pad in the ham. - -In FRONT OF THE LEG AND INSTEP the _Anter. Tibial Artery_ descends -along middle of front of leg and instep. Compress artery above wound. - -In the SOLE OF THE FOOT the _Post. Tibial and Peroneal Arteries_ -descend behind ankle-bones; the former supplies branches, which spread -out on sole of foot. Compress by a pad behind inner ankle-bone; if this -fails, place pads behind outer ankle-bone and on middle of front of the -ankle. - -In dislocations generally, and displacement of cartilage, tendons &c., -and also sprains and bruises, flannels soaked in warm water may be -applied frequently, or warm bran poultices. This kind of treatment will -almost always be suitable in the first instance. After some time has -elapsed, when a little inflammation sets in, which mostly occurs some -hours after the injury has been sustained, apply cloths soaked in cold -water or cooling lotion, and repeat them as often as they get dry; if -they are pleasant when applied, that will be an indication that they -are suitable. - -Displacement of cartilage, tendons, and similar injuries as Mr. -Jackson points out are of frequent occurrence, and require very close -attention and considerable experience to understand them. Theory is -quite insufficient of itself to enable an operator to ascertain the -nature of, and rectify the displacement. Such cases may be remedied -by a simple manipulation, but it must be a carefully studied one, and -acquired by constant practice. - -Another form of accident is that of ruptured muscles which frequently -come under the Bone-setter’s care; an illustration of a ruptured biceps -is given in fig. 35 and fig. 38, shows the _rectus femioris_ rupture. - -These useful hints can hardly be called superfluous in a manual on the -art of the Bone-setter, which is admittedly “a neglected corner of the -domain of surgery.” - - - - -CHAPTER IX. - -_THE TESTIMONY OF MY PATIENTS._ - - - ——“If our virtues - Did not go forth of us, ’twere all alike as if we had them - not.”—_Shakespeare._ - -In the foregoing pages I have quoted the testimony of many persons of -eminence who have been relieved of their ailments and cured by the art -of the Bone-setter, when regular surgeons have failed to accomplish -that desirable result. One, at least, of the cases thus published was -contributed by one of my own patients without my knowledge. I have -thought it my duty in vindicating my special art to give prominence -to the opinion of others. I have shown how the sneers of the faculty -have been turned to doubts, and under many who went forth to scoff at -the despised “Bone-setter” remained to pray. Our so-called secrets -have been appropriated and published, but our skill and reputation -remain. In justice to myself I have added the testimony of a few of -the many hundred patients who have sought and found relief at my -hands. These testimonies are very gratifying to me as they include the -Lord-Lieutenant of Warwickshire, and many clergymen and gentlemen of -reputation and position, as well as a few of the general patients who -from day to day and from week to week seek relief at my hands. - - - STONELEIGH ABBEY, KENILWORTH, - - _April 22nd, 1881_. - - Lord Leigh has much pleasure in stating that Mr. Matthews - Bennett is a very skilful operator, and has attended him and - several of his neighbours and servants on various occasions - with very great success. - - - SPOTTISWOOD, - - _July 10th, 1882_. - - Lady John Scott begs to say that she has known several cases - which were in the hands of Mr. Matthews Bennett, and she has - always heard his treatment spoken of with the greatest praise, - and in many instances which has come under her observation he - was invariably successful. She has more than once sent for - him in preference to any one else, for people in whom she was - interested. - - - WILLOUGHBY HOUSE, LEAMINGTON, - - _February 14th, 1883_. - - Miss Holy has taken every opportunity of mentioning Mr. - Matthews Bennett’s skill in his profession. - - Of his successful treatment of her sprains, she can speak - with confidence—not only from her own experience, but from - personal knowledge of other cases. - - - RUGBY, - - _March 17th, 1882_. - - I have much pleasure in stating that Mr. G. Matthews Bennett - attended me for a broken foot, and that his treatment was so - successful, that for the last eight years I have been able to - walk with much ease and comfort. - - - R. DIXON, D.D., - - _Hon. Canon of Worcester, and Vicar of - St. Matthews, Rugby_. - - - 12, CALTHORPE ROAD, BANBURY, - - _January 9th, 1882_. - - The Rev. C. F. Nightingale has known Mr. Matthews Bennett for - several years, and can testify with pleasure to the great - skill with which Mr. Bennett has treated him, as also friends - of his. - - - DONINGTON RECTORY, WOLVERHAMPTON, - - _December 11th, 1883_. - - I have great pleasure in bearing testimony to the proper - attention and remarkable skill shown by Mr. G. Matthews - Bennett, of Leamington, in every case which has come under my - cognizance. - - In two cases especially he has been enabled to restore the use - of limbs, which had become useless partly from accident and - partly from the insufficient or defective treatment which they - had before received. - - H. G. de BUNSEN, M.A., - - _Rector of Donington, Rural Dean - of Shifnal_. - - The Rev. H. G. de Bunsen also writing under date December 1st, - 1882, gives particulars of one of the cases he mentions:— - - “My dear Sir,—It was only yesterday that I could catch the - wife of Richard Wood, of Albrighton, to give me particulars - of his accident, of his lameness, and your care. He is about - 50 years old. It was in April, 1880, that he “sprained” (or - I believe rather dislocated somehow) his foot by its turning - on one side when he trod on and slipped from a brick. He had - his club doctor, who treated it and called it a sprain, sent - lotion, &c. But for 17 weeks he could not tread on it, and was - in pain all the time. Then me hearing of it sent him to you - in August. He was driven to the station at Albrighton, and - from Snow Hill to Bullivant’s Hotel, where you saw him, moved - his foot up and down, then gave a strong jerk up, it snacked, - and you bandaged it, and he walked up and down the room for - the first time after the accident! He came again to you a - fortnight after driving to the Albrighton Station, and from - Snow Hill to your Hotel. But he walked back to the station by - your permission; his wife accompanied him both times. He came - once more to show you his foot a fortnight after that, but - his wife did not think it necessary to accompany him, and he - walked both ways without feeling any the worse. - - It was not till April, 1881, that he went regularly to work - again, and he has continued at it without intermission.” - - - WHILTON RECTORY, DAVENTRY, - - _April 28th, 1881_. - - Dear Sir,—I have pleasure in stating that you successfully - replaced a dislocation of my knee-joint some years since, and - that I have every confidence in your skill as a Bone-setter. - I shall be glad to learn that your practice is extending and - with every good wish. - - I am, yours faithfully, - - R. SKIPWORTH. - - - KILBY HOUSE, LEAMINGTON, - - _December 6th, 1883_. - - Dear Sir,—I have much pleasure in bearing testimony to the - skilful manner you treated me for a contracted shoulder - some years since, having now free use of the shoulder, and - suffering no ill effects from the injury. - - Yours truly, - - J. GLOVER, J.P. - - - CLIFF HILL, WARWICK, - - _April 27th, 1881_. - - Dear Sir,—I have great pleasure in saying that I am indebted - to your skill in curing my knee after twelve months’ treatment - of surgeons, except a twinge now and then I believe the joint - is perfectly sound. - - Yours, - - JAMES PLUCKNETT. - - - 51, ST. JOHN STREET, COVENTRY, - - _December 31st, 1880_. - - Sir,—It is with a spirit of deep thankfulness that I write to - tell you that I have now been able to resume my duties to-day. - - On February 19, while in performance of duty I was knocked - down and severely injured by an infuriated cow. For these - injuries I was treated first at the Coventry Hospital, and - afterwards at the General Hospital, Birmingham, also by an - eminent physician or surgeon, but from these institutions nor - from the gentleman mentioned did I seem to derive any benefit, - and it was only when examined by you (Nov. 8th) that I was - aware that any bone was injured. From that time my improvement - has been rapid, and to-day I am able to work again. - - I need scarcely say I consider myself under a deep debt of - gratitude to you, and shall at all times be anxious to serve - you by any means in my power. - - I am, yours obediently, - - HENRY ALLEN, - - _Foreman Porter, Coventry Station_. - - - 14, PORTLAND ROAD, LEAMINGTON, - - _November 29th, 1883_. - - Dear Sir,—I have very much pleasure in testifying to the - marked ability with which you restored my arm in 1880 when - suffering from a very severe sprain of the ligaments in - consequence of being thrown from my trap. Medical men, whom I - called in at the time, failed to discern the real diagnosis of - the case. - - I am, dear Sir, Yours very truly, - - J. CROAD. - - - CUBBINGTON, LEAMINGTON, - - _December, 1883_. - - Dear Sir,—I hear you are publishing a book, and thought, - perhaps, you would like my case. On April 4, 1882, I came to - your house at Milverton suffering from a dislocation of the - jaw which you reduced at once. I might add that a medical man - had been attending me for a week previously, but could not - reduce the dislocation. - - Yours very gratefully, - - ELLEN STANLEY. - - - 44, PORLEN ROAD, WEST KENSINGTON PARK, LONDON, - - _February 23rd, 1882_. - - Dear Sir,—About nine years ago I consulted you about my - knee. I had been under treatment for synovites in my right - knee by two eminent surgeons for twelve weeks, and afterwards - an in-patient of Leicester Infirmary. I left the latter - institution on crutches and with a stiff joint. After six - weeks of your treatment I had recovered full use of my leg and - resumed my ordinary employment. Since then I severely injured - my other knee, and your treatment of that was eminently - satisfactory. - - Yours faithfully, - - WILLIAM KNIGHT. - - - THOMLY HALL, THAME, OXON, - _November 28th, 1882_. - - Dear Sir,—It is a pleasure as well as a duty to bear - testimony to the great benefit I have derived from your skill - in restoring my shoulder. It had been out of joint nine - months, and was very badly contracted, now I can use it as - well as the other. - - I am, dear Sir, Yours very truly, - - ELIZ. WIGGINS. - - - 36, MARKET PLACE, BANBURY, - - _November 9th, 1882_. - - Dear Sir,—I feel great pleasure in sending you my testimonial - to your skill. Having been under Dr. Deyons, of Fenny - Stratford, with fracture and dislocation of elbow for three - months, and who left me at that time a complete cripple, I was - not able to feed myself or do anything at my trade. I then had - advice from two prominent medical doctors of this town, but - neither would undertake the operation, and the advice received - from both was go to Guy’s Hospital. I then presented myself to - you, and you have succeeded far better than I anticipated, for - I am now able to work at my trade and earn my living, and my - arm is getting stronger every day. - - I am, gratefully yours, - - FRED. H. HARTALL. - - - POUNDON, NEAR BICESTER, OXON, - - _December 1st, 1883_. - - Dear Sir,—About twelve months ago I was suffering from pains - in my left shoulder which I thought was rheumatism. After - waiting about four months I consulted my medical man, who said - the collar-bone was broken. He set it and attended me about a - month. Being no better I was advised to go to you. You told me - it had not been broken, but that the ligaments of the shoulder - were contracted, and I could not got my hand higher than my - head. After your treatment and advice I am happy to say it is - now well and strong, and had it not been for your skill, I - feel sure I should have lost the use of it. - - Yours, - - SARAH DEELEY. - - - GUY’S CLIFFE, WARWICK, 1875. - - Dear Sir,—I have great pleasure in stating I am quite sound - again. Also allow me to state I have every confidence in - your skill as a practical Bone-setter. You relieved me after - suffering for two months with dislocation of my knee. I could - not get my heel to the ground till one Sunday morning (which - I shall never forget) when I sent for you and you put my knee - in. I was able to walk at once free from pain. I had been - under our local surgeon some time and received no benefit. - - I am, yours respectfully, - - HEAD COACHMAN to the Lady Charles Bertie Percy. - - - SNITTERFIELD, STRATFORD-ON-AVON, - - _January 27th, 1883_. - - Dear Sir,—It is with much pleasure that I write to thank - you for your kindness and skilful attention to my arm. I may - mention on the 10th of October, 1882, I was thrown from my - bicycle near Dunchurch, and severely fractured my left elbow. - I saw a surgeon at Stratford-on-Avon on the 12th and 16th of - October after the accident, who said there was no fracture - or dislocation. Not feeling satisfied, my employer gave me - a ticket to go into the Kidderminster Hospital. The doctor - there told me my elbow was ruined for life—that I should - have a stiff joint; the thought of it gave me an awful turn, - knowing that the means of earning my living would be very - much impaired. I therefore made up my mind to go to you, and - am now very thankful I did go, for after two months of your - skilful treatment I can use my arm again quite freely. I find - it no detriment to my work whatever, and am able to follow my - occupation as well as before the accident. - - With very many thanks, I remain, - Yours very gratefully, - - JOHN NEAL. - - - FLOODE ROW, CHILVERS COTEN, NUNEATON, - - _August 9th, 1881_. - - John Knight wishes to say that he has every confidence in - Mr. Matthews Bennett’s skill having been under his treatment - several times with broken bones and dislocations, the last of - which was a fracture of both thighs and a collar bone caused - by a fall of earth in a coal pit belonging to Mr. Newdegate, - M.P., January 2, 1875, and with God’s blessing and Mr. - Bennett’s kind skill and attention he is now perfectly well. - - (Signed) JOHN KNIGHT. - - To G. Matthews Bennett, Esq., - Specialist, &c., Milverton, Leamington. - - - - -FOOTNOTES: - -[1] See _Lancet_, May 27th, 1871. - -[2] George Moore, merchant and philanthropist. By Samuel Smiles, -L.L.D., author of “Lives of the Engineers,” etc. London: Routledge & -Sons, 1878. - -[3] Chambers’ Journal, fourth series, No. 776, pp. 711, 712. - -[4] Vol. VI. pp. 82 (1872). - -[5] Vol. ix. i., p.p. 750; vol. ii. p.p., 80., 1875; p.p., -567.—_Lancet._ - -[6] Dr. Dacre Fox touches on this question in his paper, p. 103-9. - -[7] Undoubtedly, as far as the metropolis is concerned, but some of the -Lancashire Bone-setters had a far more extensive practice.—G. M. B. - - -Printed by G. J. PARRIS, 57, Greek Street, Soho, London. - - - - - -End of the Project Gutenberg EBook of The Art of the Bone-Setter, by -George Matthews Bennett - -*** END OF THIS PROJECT GUTENBERG EBOOK THE ART OF THE BONE-SETTER *** - -***** This file should be named 50568-0.txt or 50568-0.zip ***** -This and all associated files of various formats will be found in: - http://www.gutenberg.org/5/0/5/6/50568/ - -Produced by Turgut Dincer and The Online Distributed -Proofreading Team at http://www.pgdp.net (This file was -produced from images generously made available by The -Internet Archive) - -Updated editions will replace the previous one--the old editions will -be renamed. - -Creating the works from print editions not protected by U.S. copyright -law means that no one owns a United States copyright in these works, -so the Foundation (and you!) can copy and distribute it in the United -States without permission and without paying copyright -royalties. Special rules, set forth in the General Terms of Use part -of this license, apply to copying and distributing Project -Gutenberg-tm electronic works to protect the PROJECT GUTENBERG-tm -concept and trademark. Project Gutenberg is a registered trademark, -and may not be used if you charge for the eBooks, unless you receive -specific permission. If you do not charge anything for copies of this -eBook, complying with the rules is very easy. You may use this eBook -for nearly any purpose such as creation of derivative works, reports, -performances and research. They may be modified and printed and given -away--you may do practically ANYTHING in the United States with eBooks -not protected by U.S. copyright law. Redistribution is subject to the -trademark license, especially commercial redistribution. - -START: FULL LICENSE - -THE FULL PROJECT GUTENBERG LICENSE -PLEASE READ THIS BEFORE YOU DISTRIBUTE OR USE THIS WORK - -To protect the Project Gutenberg-tm mission of promoting the free -distribution of electronic works, by using or distributing this work -(or any other work associated in any way with the phrase "Project -Gutenberg"), you agree to comply with all the terms of the Full -Project Gutenberg-tm License available with this file or online at -www.gutenberg.org/license. - -Section 1. General Terms of Use and Redistributing Project -Gutenberg-tm electronic works - -1.A. By reading or using any part of this Project Gutenberg-tm -electronic work, you indicate that you have read, understand, agree to -and accept all the terms of this license and intellectual property -(trademark/copyright) agreement. If you do not agree to abide by all -the terms of this agreement, you must cease using and return or -destroy all copies of Project Gutenberg-tm electronic works in your -possession. If you paid a fee for obtaining a copy of or access to a -Project Gutenberg-tm electronic work and you do not agree to be bound -by the terms of this agreement, you may obtain a refund from the -person or entity to whom you paid the fee as set forth in paragraph -1.E.8. - -1.B. "Project Gutenberg" is a registered trademark. It may only be -used on or associated in any way with an electronic work by people who -agree to be bound by the terms of this agreement. There are a few -things that you can do with most Project Gutenberg-tm electronic works -even without complying with the full terms of this agreement. See -paragraph 1.C below. There are a lot of things you can do with Project -Gutenberg-tm electronic works if you follow the terms of this -agreement and help preserve free future access to Project Gutenberg-tm -electronic works. See paragraph 1.E below. - -1.C. The Project Gutenberg Literary Archive Foundation ("the -Foundation" or PGLAF), owns a compilation copyright in the collection -of Project Gutenberg-tm electronic works. Nearly all the individual -works in the collection are in the public domain in the United -States. If an individual work is unprotected by copyright law in the -United States and you are located in the United States, we do not -claim a right to prevent you from copying, distributing, performing, -displaying or creating derivative works based on the work as long as -all references to Project Gutenberg are removed. Of course, we hope -that you will support the Project Gutenberg-tm mission of promoting -free access to electronic works by freely sharing Project Gutenberg-tm -works in compliance with the terms of this agreement for keeping the -Project Gutenberg-tm name associated with the work. You can easily -comply with the terms of this agreement by keeping this work in the -same format with its attached full Project Gutenberg-tm License when -you share it without charge with others. - -1.D. The copyright laws of the place where you are located also govern -what you can do with this work. Copyright laws in most countries are -in a constant state of change. If you are outside the United States, -check the laws of your country in addition to the terms of this -agreement before downloading, copying, displaying, performing, -distributing or creating derivative works based on this work or any -other Project Gutenberg-tm work. The Foundation makes no -representations concerning the copyright status of any work in any -country outside the United States. - -1.E. Unless you have removed all references to Project Gutenberg: - -1.E.1. The following sentence, with active links to, or other -immediate access to, the full Project Gutenberg-tm License must appear -prominently whenever any copy of a Project Gutenberg-tm work (any work -on which the phrase "Project Gutenberg" appears, or with which the -phrase "Project Gutenberg" is associated) is accessed, displayed, -performed, viewed, copied or distributed: - - This eBook is for the use of anyone anywhere in the United States and - most other parts of the world at no cost and with almost no - restrictions whatsoever. You may copy it, give it away or re-use it - under the terms of the Project Gutenberg License included with this - eBook or online at www.gutenberg.org. If you are not located in the - United States, you'll have to check the laws of the country where you - are located before using this ebook. - -1.E.2. If an individual Project Gutenberg-tm electronic work is -derived from texts not protected by U.S. copyright law (does not -contain a notice indicating that it is posted with permission of the -copyright holder), the work can be copied and distributed to anyone in -the United States without paying any fees or charges. If you are -redistributing or providing access to a work with the phrase "Project -Gutenberg" associated with or appearing on the work, you must comply -either with the requirements of paragraphs 1.E.1 through 1.E.7 or -obtain permission for the use of the work and the Project Gutenberg-tm -trademark as set forth in paragraphs 1.E.8 or 1.E.9. - -1.E.3. If an individual Project Gutenberg-tm electronic work is posted -with the permission of the copyright holder, your use and distribution -must comply with both paragraphs 1.E.1 through 1.E.7 and any -additional terms imposed by the copyright holder. Additional terms -will be linked to the Project Gutenberg-tm License for all works -posted with the permission of the copyright holder found at the -beginning of this work. - -1.E.4. Do not unlink or detach or remove the full Project Gutenberg-tm -License terms from this work, or any files containing a part of this -work or any other work associated with Project Gutenberg-tm. - -1.E.5. Do not copy, display, perform, distribute or redistribute this -electronic work, or any part of this electronic work, without -prominently displaying the sentence set forth in paragraph 1.E.1 with -active links or immediate access to the full terms of the Project -Gutenberg-tm License. - -1.E.6. You may convert to and distribute this work in any binary, -compressed, marked up, nonproprietary or proprietary form, including -any word processing or hypertext form. However, if you provide access -to or distribute copies of a Project Gutenberg-tm work in a format -other than "Plain Vanilla ASCII" or other format used in the official -version posted on the official Project Gutenberg-tm web site -(www.gutenberg.org), you must, at no additional cost, fee or expense -to the user, provide a copy, a means of exporting a copy, or a means -of obtaining a copy upon request, of the work in its original "Plain -Vanilla ASCII" or other form. Any alternate format must include the -full Project Gutenberg-tm License as specified in paragraph 1.E.1. - -1.E.7. Do not charge a fee for access to, viewing, displaying, -performing, copying or distributing any Project Gutenberg-tm works -unless you comply with paragraph 1.E.8 or 1.E.9. - -1.E.8. You may charge a reasonable fee for copies of or providing -access to or distributing Project Gutenberg-tm electronic works -provided that - -* You pay a royalty fee of 20% of the gross profits you derive from - the use of Project Gutenberg-tm works calculated using the method - you already use to calculate your applicable taxes. The fee is owed - to the owner of the Project Gutenberg-tm trademark, but he has - agreed to donate royalties under this paragraph to the Project - Gutenberg Literary Archive Foundation. Royalty payments must be paid - within 60 days following each date on which you prepare (or are - legally required to prepare) your periodic tax returns. Royalty - payments should be clearly marked as such and sent to the Project - Gutenberg Literary Archive Foundation at the address specified in - Section 4, "Information about donations to the Project Gutenberg - Literary Archive Foundation." - -* You provide a full refund of any money paid by a user who notifies - you in writing (or by e-mail) within 30 days of receipt that s/he - does not agree to the terms of the full Project Gutenberg-tm - License. You must require such a user to return or destroy all - copies of the works possessed in a physical medium and discontinue - all use of and all access to other copies of Project Gutenberg-tm - works. - -* You provide, in accordance with paragraph 1.F.3, a full refund of - any money paid for a work or a replacement copy, if a defect in the - electronic work is discovered and reported to you within 90 days of - receipt of the work. - -* You comply with all other terms of this agreement for free - distribution of Project Gutenberg-tm works. - -1.E.9. If you wish to charge a fee or distribute a Project -Gutenberg-tm electronic work or group of works on different terms than -are set forth in this agreement, you must obtain permission in writing -from both the Project Gutenberg Literary Archive Foundation and The -Project Gutenberg Trademark LLC, the owner of the Project Gutenberg-tm -trademark. Contact the Foundation as set forth in Section 3 below. - -1.F. - -1.F.1. Project Gutenberg volunteers and employees expend considerable -effort to identify, do copyright research on, transcribe and proofread -works not protected by U.S. copyright law in creating the Project -Gutenberg-tm collection. Despite these efforts, Project Gutenberg-tm -electronic works, and the medium on which they may be stored, may -contain "Defects," such as, but not limited to, incomplete, inaccurate -or corrupt data, transcription errors, a copyright or other -intellectual property infringement, a defective or damaged disk or -other medium, a computer virus, or computer codes that damage or -cannot be read by your equipment. - -1.F.2. LIMITED WARRANTY, DISCLAIMER OF DAMAGES - Except for the "Right -of Replacement or Refund" described in paragraph 1.F.3, the Project -Gutenberg Literary Archive Foundation, the owner of the Project -Gutenberg-tm trademark, and any other party distributing a Project -Gutenberg-tm electronic work under this agreement, disclaim all -liability to you for damages, costs and expenses, including legal -fees. YOU AGREE THAT YOU HAVE NO REMEDIES FOR NEGLIGENCE, STRICT -LIABILITY, BREACH OF WARRANTY OR BREACH OF CONTRACT EXCEPT THOSE -PROVIDED IN PARAGRAPH 1.F.3. YOU AGREE THAT THE FOUNDATION, THE -TRADEMARK OWNER, AND ANY DISTRIBUTOR UNDER THIS AGREEMENT WILL NOT BE -LIABLE TO YOU FOR ACTUAL, DIRECT, INDIRECT, CONSEQUENTIAL, PUNITIVE OR -INCIDENTAL DAMAGES EVEN IF YOU GIVE NOTICE OF THE POSSIBILITY OF SUCH -DAMAGE. - -1.F.3. LIMITED RIGHT OF REPLACEMENT OR REFUND - If you discover a -defect in this electronic work within 90 days of receiving it, you can -receive a refund of the money (if any) you paid for it by sending a -written explanation to the person you received the work from. If you -received the work on a physical medium, you must return the medium -with your written explanation. The person or entity that provided you -with the defective work may elect to provide a replacement copy in -lieu of a refund. If you received the work electronically, the person -or entity providing it to you may choose to give you a second -opportunity to receive the work electronically in lieu of a refund. If -the second copy is also defective, you may demand a refund in writing -without further opportunities to fix the problem. - -1.F.4. Except for the limited right of replacement or refund set forth -in paragraph 1.F.3, this work is provided to you 'AS-IS', WITH NO -OTHER WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING BUT NOT -LIMITED TO WARRANTIES OF MERCHANTABILITY OR FITNESS FOR ANY PURPOSE. - -1.F.5. Some states do not allow disclaimers of certain implied -warranties or the exclusion or limitation of certain types of -damages. If any disclaimer or limitation set forth in this agreement -violates the law of the state applicable to this agreement, the -agreement shall be interpreted to make the maximum disclaimer or -limitation permitted by the applicable state law. The invalidity or -unenforceability of any provision of this agreement shall not void the -remaining provisions. - -1.F.6. INDEMNITY - You agree to indemnify and hold the Foundation, the -trademark owner, any agent or employee of the Foundation, anyone -providing copies of Project Gutenberg-tm electronic works in -accordance with this agreement, and any volunteers associated with the -production, promotion and distribution of Project Gutenberg-tm -electronic works, harmless from all liability, costs and expenses, -including legal fees, that arise directly or indirectly from any of -the following which you do or cause to occur: (a) distribution of this -or any Project Gutenberg-tm work, (b) alteration, modification, or -additions or deletions to any Project Gutenberg-tm work, and (c) any -Defect you cause. - -Section 2. Information about the Mission of Project Gutenberg-tm - -Project Gutenberg-tm is synonymous with the free distribution of -electronic works in formats readable by the widest variety of -computers including obsolete, old, middle-aged and new computers. It -exists because of the efforts of hundreds of volunteers and donations -from people in all walks of life. - -Volunteers and financial support to provide volunteers with the -assistance they need are critical to reaching Project Gutenberg-tm's -goals and ensuring that the Project Gutenberg-tm collection will -remain freely available for generations to come. In 2001, the Project -Gutenberg Literary Archive Foundation was created to provide a secure -and permanent future for Project Gutenberg-tm and future -generations. To learn more about the Project Gutenberg Literary -Archive Foundation and how your efforts and donations can help, see -Sections 3 and 4 and the Foundation information page at -www.gutenberg.org - - - -Section 3. Information about the Project Gutenberg Literary Archive Foundation - -The Project Gutenberg Literary Archive Foundation is a non profit -501(c)(3) educational corporation organized under the laws of the -state of Mississippi and granted tax exempt status by the Internal -Revenue Service. The Foundation's EIN or federal tax identification -number is 64-6221541. Contributions to the Project Gutenberg Literary -Archive Foundation are tax deductible to the full extent permitted by -U.S. federal laws and your state's laws. - -The Foundation's principal office is in Fairbanks, Alaska, with the -mailing address: PO Box 750175, Fairbanks, AK 99775, but its -volunteers and employees are scattered throughout numerous -locations. Its business office is located at 809 North 1500 West, Salt -Lake City, UT 84116, (801) 596-1887. Email contact links and up to -date contact information can be found at the Foundation's web site and -official page at www.gutenberg.org/contact - -For additional contact information: - - Dr. Gregory B. Newby - Chief Executive and Director - gbnewby@pglaf.org - -Section 4. Information about Donations to the Project Gutenberg -Literary Archive Foundation - -Project Gutenberg-tm depends upon and cannot survive without wide -spread public support and donations to carry out its mission of -increasing the number of public domain and licensed works that can be -freely distributed in machine readable form accessible by the widest -array of equipment including outdated equipment. Many small donations -($1 to $5,000) are particularly important to maintaining tax exempt -status with the IRS. - -The Foundation is committed to complying with the laws regulating -charities and charitable donations in all 50 states of the United -States. Compliance requirements are not uniform and it takes a -considerable effort, much paperwork and many fees to meet and keep up -with these requirements. We do not solicit donations in locations -where we have not received written confirmation of compliance. To SEND -DONATIONS or determine the status of compliance for any particular -state visit www.gutenberg.org/donate - -While we cannot and do not solicit contributions from states where we -have not met the solicitation requirements, we know of no prohibition -against accepting unsolicited donations from donors in such states who -approach us with offers to donate. - -International donations are gratefully accepted, but we cannot make -any statements concerning tax treatment of donations received from -outside the United States. U.S. laws alone swamp our small staff. - -Please check the Project Gutenberg Web pages for current donation -methods and addresses. Donations are accepted in a number of other -ways including checks, online payments and credit card donations. To -donate, please visit: www.gutenberg.org/donate - -Section 5. General Information About Project Gutenberg-tm electronic works. - -Professor Michael S. Hart was the originator of the Project -Gutenberg-tm concept of a library of electronic works that could be -freely shared with anyone. For forty years, he produced and -distributed Project Gutenberg-tm eBooks with only a loose network of -volunteer support. - -Project Gutenberg-tm eBooks are often created from several printed -editions, all of which are confirmed as not protected by copyright in -the U.S. unless a copyright notice is included. Thus, we do not -necessarily keep eBooks in compliance with any particular paper -edition. - -Most people start at our Web site which has the main PG search -facility: www.gutenberg.org - -This Web site includes information about Project Gutenberg-tm, -including how to make donations to the Project Gutenberg Literary -Archive Foundation, how to help produce our new eBooks, and how to -subscribe to our email newsletter to hear about new eBooks. - |